Medical Policy Specialist researches and designs criteria to determine policy guidelines used in review of patient cases to ensure only medically appropriate services are reimbursed. Recommends a policy and process that ensure alignment with company guidelines and nationally accepted medical/coding standards. Being a Medical Policy Specialist establishes the proper codes to use for claims processing. Responds to questions from medical staff and communicates details about policy and guidelines. Additionally, Medical Policy Specialist requires a bachelor's degree. Typically reports to a supervisor or manager. Requires Registered Nurse RN. The Medical Policy Specialist gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Medical Policy Specialist typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)
Position Summary:
The Medical Billing and Coding Specialist position needs to have a broad knowledge of healthcare insurance billing including CPT and ICD10 codes, preparing and submitting clean claims to insurance companies, posting both patient and insurance payments, recognizing correct insurance adjustments, following-up on insurance claim denials and appeals, and acquiring insurance authorizations. This position requires the ability to work independently, accomplish goals, excellent customer service and communication skills, creativity, patience, and flexibility.
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Job Type: Full-time
Pay: $17.00 - $19.00 per hour
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Work Location: In person
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0 Medical Policy Specialist jobs found in Abilene, TX area