The Manager, Coding and Reimbursement Policy is responsible for managing the day to day programs, tools, and functions related to interventional radiology coding and reimbursement. The Manager reports to the Director, Economics and Practice Development and collaborates closely with other staff in the Health Policy & Quality division, SIR communications staff, and SIR governance staff. The Manager works with a wide range of physician volunteers to develop and manage coding and reimbursement proposals that will enable physicians providing image-guided minimally invasive therapies to succeed on the practice model of their choice.
Essential Functions and Responsibilities
Develop and submit Code Change Proposals (CCPs) to the CPT Editorial Panel in conjunction with SIR volunteers and consultants, including both new codes and code revisions required through the RUC RAW process.
Screen CCPs from other societies before each CPT Editorial Panel Identify and evaluate those that require SIR comment.
Provide staff support to physician volunteers representing SIR at the CPT Editorial Panel Meetings three times per year, including coordinating and interacting with other medical specialties and industry, on coding and reimbursement issues.
Identify NCCI edits that may require SIR comment. Assist the volunteers and the Director to author NCCI comment letters, as needed.
Monitor codes scheduled for “sunsetting” by the CPT Editorial Panel and solicit comments, as needed.
Serve as Staff Liaison to the Coding and Reimbursement Subcommittee of the Economics Committee. Assist the Director with staffing the Economics Committee.
Evaluate coding questions from members. Author initial and suggested responses to those questions and solicit committee review. Identify topics that should be communicated to the broader membership through SIR Connect and the IRQ Coding Q&A column.
Lead annual revisions to the SIR “IR Coding Update.”
Organize and support volunteer engagement on current CMS Episode-cost Measure development panels.
Organize volunteer travel to CPT Editorial Panel meetings, CMS Episode-cost Measure meetings, and meetings with CMS and other payers, as needed.
Secondary Functions and Responsibilities
Assist the Director and the RUC consultant with distributing and tabulating surveys required by the AMA’s Relative-value Update Committee process.
Assist the Director and the RUC consultant with collecting and assessing practice expense data from volunteers.
Assist with payment advocacy activities through the Carrier Advocacy program.
Assist the Director with practice development subcommittee activities and developing and maintaining practice management toolkits, as needed.
Knowledge, Skills and Abilities
Understanding of, and experience with, physician and/or hospital payment, including CPT coding, ICD-10 coding and HCPCS coding
Strong communication skills, including the ability to work constructively and collaboratively with physician volunteers and to build constructive working relationships with coding staff from other societies.
Ability to multi-task, prioritize, and successfully manage multiple ongoing projects. Possesses a keen eye for details.
Ability to proactively identify issues in coding and reimbursement and propose effective resolutions
Excellent communications skills, both oral and written.
Computer skills: proficiency in Microsoft Office
Coding certification (e.g. CPC, RCC or CIRCC) required.
About Society of Interventional Radiology
The Society of Interventional Radiology (SIR) is located in Fairfax, Virginia, SIR is a national organization (approx. 40 staff members) of physicians, scientists, and allied health professionals dedicated to improving public health through disease management and minimally invasive, image-guided therapeutic interventions. Today, SIR continues to maintain steady membership growth with more than 6,000 physician and allied health care members.