Employer: Planet Pharma
This person will be accountable for providing comprehensive support in identification and verification of various medical and pharmacy codes for RWE research projects to the team.
Responsibilities include:
- Review project synopsis and protocol and search/identify medical and pharmacy codes, such as ICD diagnosis and procedure codes, DRG, CPT, HCPCS, LOINC, NDC, USC, brand and generic names of medicines, bill types and revenue codes, etc based on conceptual definitions of diagnosis, treatment, lab testing and outcomes.
- Compile lists of medical and pharmacy codes for inclusion or/and exclusion criteria of patient cohorts as operational definitions of diagnosis, treatment, lab testing and outcomes.
- Verify medical and pharmacy codes and ensure that all codes are accurate, inclusive, complete, and consistent.
Required Knowledge, Skills, and Abilities
- Multiple years’ experience in support of medical billing and coding is required.
- Demonstrate a clear understanding medical terminology and medical codes in a variety of healthcare settings, including ICD diagnosis and procedure codes, DRG, CPT, HCPCS, LOINC, NDC, USC, brand and generic names of medicines, bill types and revenue codes, etc.
- Must be able to use any repository and tool of medical and pharmacy codes for code search in a comprehensive manner.
- Experience in working with medical and pharmacy claim data is preferred.
- Experience in real-world evidence or/and healthcare outcomes research is preferred.
- Manage competing priorities and communicates realistic timelines for completion of assigned tasks when making commitments.
- Keen attention to details.
Required/Preferred Education and Licenses
- Certificate of training related to medical billing and coding is required, such as the AAPC Certified Professional Code Certificate or a functional equivalent.
- Registered Nurses are preferred.
The Planet Group of Companies is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.