Associate Director Reimbursement Policy will work with the Director, Reimbursement Policy and Quality to support APAs coding and payment policy efforts and provide comprehensive written research related to the Physician Fee Schedule and value-based payment programs.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Serve as liaison to the AMA CPT and RUC. Activities include document review, meeting preparation (including drafting of coding proposals, RUC survey process), meeting attendance, and research as necessary.
Develop and maintain communication channels with CMS, other federal and state agencies, and other relevant organizations (e.g., MedPAC, GAO) to help APA provide feedback on activities that relate to coding and payment.
Attend and represent APA at coalition meetings.
Analyze impact of federal regulatory and legislative proposals on coding and payment policy for psychiatry and develop APA policy positions, and assist with related issues, as needed.
Maintain knowledge of Medicare and Medicaid policies relating to all aspects of psychiatric care.
Serve as a lead point of contact for members in resolving problems with Medicare and other third-party payers, primarily in the areas of payment and coverage policy. Collaborate with Manager of the Practice Management Helpline and provide coverage for the Helpline
Develop educational materials (i.e., FAQs, Webinars) for APA members on CPT coding and documentation, and major coverage policies.
Staff liaison for Committee on RBRVS, Codes and Reimbursement and Committee on Reimbursement for Psychiatric Care
REQUIRED SKILLS, EXPERIENCE, AND QUALIFICATIONS
A bachelors degree is required, a master's degree in public health, public policy, or health services administration desired.
Interested candidates should have knowledge of or experience in medical coding with a broad understanding of the regulatory environment and the policy implications of medical coding; or, have experience with private and public payers. CPT and/or RUC experience preferred.
Knowledge of federal regulatory and legislative processes with emphasis on the Physician Fee Schedule and other value-based payment programs and demonstrated policy analysis experience is strongly preferred.
Strong writing skills and experience responding to regulatory comments
Experience in government relations and physician issues regarding Medicare and private payer policies and health information technology are a plus
American Psychiatric Association (APA) is the world's largest psychiatric organization, with over 38,500 U.S. and international member physicians and 240 employees. Its vision is a society that has available, accessible quality psychiatric diagnosis and treatment. APA has excellent benefits, including medical, dental, 401k, flexible spending accounts, and tuition assistance. The APA is located in Washington, D.C. within walking distance of the L'Enfant Plaza Metro stop.
