Avera Health
Sioux Falls, SD
Medical Necessity Coordinator Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter. Accountable to coordinate National Coverage and Determination (NCD) policies, Local Coverage Determination (LCD) policies, coverage policies for various payers and Medicare articles and any other activities related to medical necessity throughout Avera. Coordination of medical necessity activities includes: implementation of policy validation processes, education to departments on medical necessity guidelines, running reports for coverage review of new or existing policies, supporting appeals process, streamlining workflow for medical necessity, serving on committees, and other duties as necessary. What you will do Establish goals for processing, researching and problem solving new, modified and deleted LCD and NCD policies as well as communicating essential information to appropriate departments and...