Coding & Coverage Access Specialist

MCRA is a leading medical device advisory firm and clinical research organization (CRO). MCRA's value contribution rests within its industry experience at integrating five business value creators—regulatory, clinical research, reimbursement, healthcare compliance, and quality assurance—to provide a dynamic, market-leading effort from concept to commercialization. MCRA's integrated application of these key value-creating functions provides unparalleled expertise for its clients. MCRA has offices in Washington, DC, Manchester, CT, New York, NY, and a global presence in Japan and Europe and serves more than 1100 clients globally. Its core focus areas of therapeutic experience include orthopedics, spine, cardiovascular, neurology, digital health, diagnostic imaging, wound care, dental, general healthcare, robotics, and in vitro diagnostic (IVD) devices.

Position Overview:

The Coding & Coverage Access Specialist is a dynamic, public-facing role that is focused on supporting a variety of patient access and reimbursement functions, with an emphasis on researching and responding to a diverse range of coding and coverage inquiries from clients, healthcare providers, and patients seeking access to innovative diagnostic and therapeutic interventions. Excellent oral and written communication skills combined with exceptional customer service skills are essential functions for this position. 

Responsibilities:

• Provide positive, proactive service to MCRA’s Patient Access Solutions (PAS) clients in support of coding hotlines and coverage access programs.
• Perform intake of cases and capture all relevant research and correspondence in MCRA’s CRM
• Answers technical coding, coverage, and reimbursement questions from providers, billing and coding staff, and sales representatives
• Stay abreast of current trends in coding and coverage support pathways for new technologies with continuing education and coding forum reviews
• Facilitate Coverage Access support to patients including performing benefit investigations, pre-authorization and denied claims appeals, in an efficient and timely manner
• Provide recurring education about the technologies and procedures supported by PAS to physicians, hospitals, patients, and other stakeholders as may be required to effect timely access to care
• Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly
• Adhere to all HIPAA compliance policies
• Ensure all work products comply fully with related guidelines, regulations, standards, policies, and mission of MCRA.
• Additional duties as assigned 

Requirements:

• Associate degree required/B.S. or B.A. preferred
• 2+ years of experience in health care, preferably in a physician practice or facility
• Coding certification (such as CPC or CPC-A) required
• Experience in health care in an administrative capacity is highly desirable, preferably in a physician practice or facility applying knowledge of billing code systems and claims processing
• Proficiency with MS Office Suite, including PowerPoint, Excel, Word, and Outlook
• Excellent oral and written communication skills
• Strong analytical and documentation proficiencies
• Ability to work effectively in a team environment
• Detail and process-oriented, with analytical and documentation proficiencies
• Self-directed individual able to manage client engagements with minimal supervision
• Demonstrates strong patient advocacy skills, and client interaction skills
• Ability to work outside of traditional business hours needed (A few days a week may be 10:30am - 7:00pm Eastern Time)
• Potential for travel to the company’s office, for meetings, and conferences.

Additional Details:

• Full Time position – Manchester, CT office based preferred – remote opportunity for well-qualified candidate

NOTE: This job description is not intended to be all-inclusive. Employee may perform other related duties as to meet the ongoing needs of the organization.

MCRA, LLC is an equal opportunity/Affirmative Action employer and does not discriminate in its selection and employment practices. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, political affiliation, sexual orientation, gender identity, marital status, disability, protected veteran status, genetic information, age, or other legally protected characteristics.