CPC Certified LCD Policy Specialist

Job Summary

A company is looking for an LCD Policy Specialist to provide clinical expertise and insight on LCD/NCD products and CMS LCD policy language.

Key Responsibilities

• Possesses strong knowledge of CMS LCDs, including structure, terminology, and documentation requirements
• Leads client discussions, explaining LCD-driven edit logic and expected outcomes
• Reviews data analytics to assess impacts of content changes and supports client escalations related to LCD edits

Required Qualifications

• Bachelor's degree in health information management, Nursing, or other healthcare-related degree
• AAPC Certified Professional Coders (CPC) certification or AHIMA Certified Coding Specialist-Physician (CCS-P) or Certified Coding Specialist (CCS) required
• Minimum of twelve years relevant healthcare experience, with at least three years in health insurance payer roles