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)
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
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.
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 :
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.
Delivering Excellent Services : - Serves Others with Compassion : Seeks to understand current and future needs of relevant stakeholders and customizes services to better address them.
Ensuring High Quality : - Performs Excellent Work : Engages regularly in formal and informal dialogue about quality; directly addresses quality issues promptly.
Managing Resources Effectively : - Demonstrates Accountability : Demonstrates a sense of ownership, focusing on and driving critical issues to closure.
Fostering Innovation : - Generates New Ideas : Proactively identifies new ideas / opportunities from multiple sources or methods to improve processes beyond conventional approaches.
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
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