Medical Policy Specialist jobs in Allensville, KY

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)

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Implementation specialist
  • Vanderbilt University Medical Center
  • Pleasant View, TN FULL_TIME
  • Discover Vanderbilt University Medical Center : Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of diverse individuals who come to work each day with the simple aim of changing the world.

    It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health recognizes that diversity is essential for excellence and innovation.

    We are committed to an inclusive environment where everyone has the chance to thrive and where your diversity of culture, thinking, learning, and leading is sought and celebrated.

    It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday.

    Vanderbilt’s mission is to advance health and wellness through preeminent programs in patient care, education, and research.

    Organization :

    VIP MS Bus Off - Gallatin

    Job Summary : JOB SUMMARY

    JOB SUMMARY

    The Patient Service Training and Implementation Specialist is responsible for creating, designing, implementing, and continually improving training programs for Patient Service Specialists at all sites.

    KEY RESPONSIBILITIES

    • Evaluates current programs for relevance and successful outcomes; conducts training needs analysis for strategic planning with office manager and other administrative personnel.
    • Designs, develops, and updates curricula and educational programs for new, existing, and upgraded EHR software, including all education materials, training manuals and schedules, exercises, and competencies;

    makes recommendations for enhancing the training and onboarding of staff.

    Coaches and facilitates the development of interpersonal and customer service skills in a patient-centered environment;

    coordinates with billing department, clinical staff, and other departments to integrate workflows.

    • Under the direction of the office manager, identifies and schedules on-site educational programs such as conflict resolution, de-escalation techniques, and soft skills training.
    • Plans, organizes, and prioritizes short- and long-term projects based on program impact and effectiveness; maintains high quality planning and tracking documents.
    • Travels to all sites and fills in as core staffing as needed.
    • Attends meetings as assigned; performs other duties as assigned

    TECHNICAL CAPABILITIES

    Our professional administrative functions include critical supporting roles in information technology and informatics, finance, administration, legal and community affairs, human resources, communications and marketing, development, facilities, and many more.

    At our growing health system, we support each other and encourage excellence among all who are part of our workforce. High-achieving employees stay at Vanderbilt Health for professional growth, appreciation of benefits, and a sense of community and purpose.

    Core Accountabilities :

    • Organizational Impact : Independently performs non-routine tasks that significantly impact team and other related teams.
    • Problem Solving / Complexity of work : Gathers and analyzes data to solve problems that arise with little or no precendent.
    • Breadth of Knowledge : Applies advanced job knowledge and has developed a breadth of skills in other areas.
    • Team Interaction : Serves as a lead for the team by providing expertise and guidance to team members.

    Core Capabilities :

    Supporting Colleagues : - Develops Self and Others : Invests time, energy, and enthusiasm in developing self / others to help improve performance e and gain knowledge in new areas.

    • Builds and Maintains Relationships : Maintains regular contact with key colleagues and stakeholders using formal and informal opportunities to expand and strengthen relationships.
    • Communicates Effectively : Recognizes group interactions and modifies one's own communication style to suit different situations and audiences.

    Delivering Excellent Services : - Serves Others with Compassion : Seeks to understand current and future needs of relevant stakeholders and customizes services to better address them.

    • Solves Complex Problems : Approaches problems from different angles; Identifies new possibilities to interpret opportunities and develop concrete solutions.
    • Offers Meaningful Advice and Support : Provides ongoing support and coaching in a constructive manner to increase employees' effectiveness.

    Ensuring High Quality : - Performs Excellent Work : Engages regularly in formal and informal dialogue about quality; directly addresses quality issues promptly.

    • Ensures Continuous Improvement : Applies various learning experiences by looking beyond symptoms to uncover underlying causes of problems and identifies ways to resolve them.
    • Fulfills Safety and Regulatory Requirements : Understands all aspects of providing a safe environment and performs routine safety checks to prevent safety hazards from occurring.

    Managing Resources Effectively : - Demonstrates Accountability : Demonstrates a sense of ownership, focusing on and driving critical issues to closure.

    • Stewards Organizational Resources : Applies understanding of the departmental work to effectively manage resources for a department / area.
    • Makes Data Driven Decisions : Demonstrates strong understanding of the information or data to identify and elevate opportunities.

    Fostering Innovation : - Generates New Ideas : Proactively identifies new ideas / opportunities from multiple sources or methods to improve processes beyond conventional approaches.

    • Applies Technology : Demonstrates an enthusiasm for learning new technologies, tools, and procedures to address short-term challenges.
    • Adapts to Change : Views difficult situations and / or problems as opportunities for improvement; actively embraces change instead of emphasizing negative elements.

    Position Qualifications :

    Responsibilities : Certifications :

    Certifications : Work Experience :

    Work Experience :

    Relevant Work Experience

    Experience Level : 2 years

    2 years

    Education :

    High School Diploma or GED (Required)

    Vanderbilt Health recognizes that diversity is essential for excellence and innovation. We are committed to an inclusive environment where everyone has the chance to thrive and to the principles of equal opportunity and affirmative action.

    EOE / AA / Women / Minority / Vets / Disabled

    Last updated : 2024-05-20

  • 14 Days Ago

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Medical QA Specialist I
  • QTC Management, Inc.
  • Pleasant View, TN FULL_TIME
  • If you're a medical professional skilled in reviewing and interpreting medical records, driven by a passion for aiding others, we're eager to connect with you!We are seeking a Medical Quality Assuranc...
  • 1 Day Ago

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Pre-Registration Specialist
  • Henry County Medical Center
  • Paris, TN OTHER
  • Job Details Job Location: Henry County Medical Center - Paris, TN Position Type: FT 80 Education Level: 2 Year Degree Salary Range: Undisclosed Travel Percentage: None Job Shift: Days Job Category: He...
  • 2 Months Ago

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Medical Site Credentialing Specialist- 1099 Contract
  • United Language Group
  • Waverly, TN FULL_TIME
  • Summary - Flexible Contractor/Freelance Opportunity 1099 IMMEDIATE NEED This is not a full-time or part-time job. This is not a set-scheduled job opportunity. The Medical Site credentialing Specialist...
  • Just Posted

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Medical Director
  • Theoria Medical
  • Dickson, TN FULL_TIME
  • Position Type: Part-time, exempt Compensation: Up to $400,000 annually monthly Medical Director Stipend Job Highlights Work-Life Balance: Competitive compensation with balanced hours. Weekend & On-Cal...
  • 17 Days Ago

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Medical Director
  • Theoria Medical
  • Clarksville, TN FULL_TIME
  • Position Type: Part-time, exempt Compensation: Up to $400,000 annually monthly Medical Director Stipend Job Highlights Work-Life Balance: Competitive compensation with balanced hours. Weekend & On-Cal...
  • 18 Days Ago

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0 Medical Policy Specialist jobs found in Allensville, KY area

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CDL-A Truck Driver - Home Weekly - Earn $1,500/Week + $5k Sign-On
  • Bestway Express, Inc.
  • Guthrie, KY
  • Bestway Express, Inc is Now Hiring CDL-A OTR Company Drivers! Home Weekly - $5,000 Sign-On Bonus Pay & Benefits: Home we...
  • 6/4/2024 12:00:00 AM

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EMTB / EMTA / Paramedic - Full Time
  • Grifols
  • Clarksville, TN
  • table.MiTabla { max-width: 1020px;!important Would you like to join an international team working to improve the future ...
  • 6/3/2024 12:00:00 AM

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CDL-A Truck Driver - Home Weekly - Earn $89k/Year + $5k Sign-On
  • Hogan Transports
  • Allensville, KY
  • Hogan Transports is now hiring CDL-A Drivers in Nashville, TN Earn $1,700+ Weekly - Home Throughout the Week! Earn Your ...
  • 6/2/2024 12:00:00 AM

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CDL-A Truck Driver - Home Weekly - Earn $89k/Year + $5k Sign-On
  • Hogan Transports
  • Olmstead, KY
  • Hogan Transports is now hiring CDL-A Drivers in Nashville, TN Earn $1,700+ Weekly - Home Throughout the Week! Earn Your ...
  • 6/2/2024 12:00:00 AM

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CDL-A Truck Driver - Home Weekly - Earn $89k/Year + $5k Sign-On
  • Hogan Transports
  • Guthrie, KY
  • Hogan Transports is now hiring CDL-A Drivers in Nashville, TN Earn $1,700+ Weekly - Home Throughout the Week! Earn Your ...
  • 6/2/2024 12:00:00 AM

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CDL-A Truck Driver - Home Weekly - Earn $89k/Year + $5k Sign-On
  • Hogan Transports
  • Adams, TN
  • Hogan Transports is now hiring CDL-A Drivers in Nashville, TN Earn $1,700+ Weekly - Home Throughout the Week! Earn Your ...
  • 6/2/2024 12:00:00 AM

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CDL-A Truck Driver - Home Weekly - Earn $1,500/Week + $5k Sign-On
  • Bestway Express, Inc.
  • Adams, TN
  • Bestway Express, Inc is Now Hiring CDL-A OTR Company Drivers! Home Weekly - $5,000 Sign-On Bonus Pay & Benefits: Home we...
  • 5/31/2024 12:00:00 AM

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EMTB / EMTA / Paramedic - Full Time
  • Grifols
  • Clarksville, TN
  • Would you like to join an international team working to improve the future of healthcare? Do you want to enhance the liv...
  • 5/28/2024 12:00:00 AM

Allensville is an census-designated place and former city in Todd County, Kentucky, in the United States. The population was 189 at the 2000 census. Settled in the 19th century and formally incorporated in 1867, the city was named for a pioneer family in the area. The city government was officially dissolved in 2017 after years of inactivity. Allensville is located at 36°42′57″N 87°4′12″W / 36.71583°N 87.07000°W / 36.71583; -87.07000 (36.715842, -87.069909). It is concentrated along Kentucky Route 102, just east of its intersection with U.S. Route 79. The community lies southeast of Elkt...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$80,696 to $98,497
Allensville, Kentucky area prices
were up 1.3% from a year ago

Medical Policy Specialist in Norfolk, VA
Guideline 9 – specialist medical procedures provides that applications for the separate representation of children with an intellectual impairment in relation to applications for special medical procedures are not subject to the means test or merits test.
February 20, 2020