Medical Policy Specialist jobs in Bethlehem, PA

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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Contract Specialist
  • B. Braun Medical Inc.
  • Allentown, PA FULL_TIME
  • Overview

    About B. Braun 

     

    B. Braun Medical Inc., a leader in infusion therapy and pain management, develops, manufactures, and markets innovative medical products and services to the healthcare industry. Other key product areas include nutrition, pharmacy admixture and compounding, ostomy and wound care, and dialysis. The company is committed to eliminating preventable treatment errors and enhancing patient, clinician and environmental safety. B. Braun Medical is headquartered in Bethlehem, Pa., and is part of the B. Braun Group of Companies in the U.S., which includes B. Braun Interventional Systems, Aesculap® and CAPS®.

     

    Globally, the B. Braun Group of Companies employs more than 64,000 employees in 64 countries. Guided by its Sharing Expertise® philosophy, B. Braun continuously exchanges knowledge with customers, partners and clinicians to address the critical issues of improving care and lowering costs. To learn more about B. Braun Medical, visit www.BBraunUSA.com.

    Responsibilities

    Position Summary:

     

    The Contract Specialist position offers a wide range of opportunities that include working in a team setting, communicating with various levels of the business along with other departments and owning their own Contract portfolio.  They will be a key contributor to the Contract Life Cycle Management of their portfolio that will ensure Master Data accuracy, quality output and timely responses to our internal and external customers.

     

    Responsibilities: Essential Duties

    • Maintains SAP (contract bolt-on), assuring correct pricing for customers and to support internal sales division.
    • Investigate, interpret, analyze, and audit cutomer’s contract pricing, as well as interact with various departments
    • (Legal, Sales, Bids, Sales Analysis, Marketing, Finance, Customer Support, Customer File), auditors and distributor partners. – Responds to inquiries concerning customer’s pricing, contract language/terms, GPO affiliation, billing plans, hierarchy and contract documents.
    • Processes contract amendments, escalations, chargebacks, Capital Equipment, credits, customs, EAP pricing (Electronic Approval Process), tier activations, and compliance.
     The job function listed is not exhaustive and shall also include any responsibilities as assigned by the Supervisor from time to time.   

    Expertise: Knowledge & Skills

    • Requires working knowledge of technical field/area of specialization. Exercises general application of principles, theories and concepts. Follows established procedures and guidelines.
    • Works under direct supervision and from detailed verbal and/or written instructions. Uses established procedures to accomplish assigned task.
    • May require some limited judgement in resolving problems.
    • Contacts are primarily with department supervisors, leads, subordinates, and peers. Occasional contact with external contractors/vendors.

     

     

    The targeted range for this role takes into account a range of factors that are considered when making compensation and hiring decisions; included but not limited to: skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. Compensation decisions are dependent on the facts and circumstances of each case.  The range provided is a reasonable estimate.

     

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    Target Based Range

    $39,880 - $55,000

    Qualifications

    Expertise: Qualifications -Education/Experience/Training/Etc

     

    Required:

    • Associate's or technical degree required. Bachelor's degree preferred.
    • 02-04 years related experience required.
    • Regular and predictable on-site attendance
    • Ability to work non-standard schedule as needed

     

    While performing the duties of this job, the employee is regularly required to sit and talk or hear. The employee frequently is required to use hands to handle or feel and reach with hands and arms. The employee is occasionally required to stand and walk. The employee must occasionally lift and/or move up to 20 pounds.

     

     

     

     

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    Additional Information

    Responsibilities: Other Duties:

     

    The preceding functions have been provided as examples of the types of work performed by employees assigned to this position. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed in this description are representative of the knowledge, skill, and/or ability required. Management reserves the right to add, modify, change or rescind the work assignments of different positions due to reasonable accommodation or other reasons.

     

    Physical Demands:

    While performing the duties of this job, the employee is expected to:

    • Light work - Exerting up to 20 lbs of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects.

    Lifting, Carrying, Pushing, Pulling and Reaching:

    • Occasionally:Reaching upward and downward, Push/pull, Stand
    • Frequently:Sit
    • Constantly:N/A

    Activities:

    • Occasionally:Climbing stairs/ladders, Push/pull, Reaching upward and downward, Standing, Walking
    • Frequently:Finger feeling, Hearing - ordinary, fine distinction, loud (hearing protection required), Seeing - depth perception, color vision, field of vision/peripheral, Sitting , Talking - ordinary, loud/quick
    • Constantly:N/A

    Environmental Conditions:

    • Occasionally:N/A
    • Frequently:N/A
    • Constantly:N/A

     

    Work Environment:

     The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

    • Noise Intensity:Moderate
    • Occasionally:Other
    • Frequently:N/A
    • Constantly:Office environment

    What We Offer

    B. Braun offers an excellent benefits package, which includes healthcare, a 401(k) plan, and tuition reimbursement. To learn more about B. Braun and our safety healthcare products or view a listing of our employment opportunities, please visit us on the internet at www.bbraunusa.com.   Through its “Sharing Expertise®” initiative, B. Braun promotes best practices for continuous improvement of healthcare products and services.

    Notices

    Equal Opportunity Employer Veterans/Disabled

  • 30 Days Ago

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Medical Billing Specialist
  • Dr. Hayman Salib Hematology & Oncology
  • Easton, PA FULL_TIME
  • Medical Billers work in healthcare settings to manage incoming and outgoing payments for medical treatment. Their role is to communicate with patients about their outstanding balance and handling the ...
  • Just Posted

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68K Medical Laboratory Specialist
  • Army National Guard
  • Allentown, PA FULL_TIME
  • The ASVAB isn’t the only test that matters in the military. A Soldier’s tissue, blood, and body fluids also need to be tested to detect and identify diseases. As a Medical Laboratory Specialist in the...
  • 17 Days Ago

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PC Support Specialist
  • Martech Medical Products
  • Harleysville, PA FULL_TIME
  • Medical Manufacturing companies seeking an experienced PC Support Specialist to investigate and resolve software and hardware issues for local and remote users.Qualifications – Associate degree (A. A....
  • 18 Days Ago

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PC Support Specialist
  • Martech Medical Products
  • Harleysville, PA FULL_TIME
  • Medical Manufacturing companies seeking an experienced PC Support Specialist to investigate and resolve software and hardware issues for local and remote users.Qualifications – Associate degree (A. A....
  • 18 Days Ago

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Organizational Development Specialist
  • B. Braun Medical Inc.
  • Bethlehem, PA FULL_TIME
  • Overview About B. Braun B. Braun Medical Inc., a leader in infusion therapy and pain management, develops, manufactures, and markets innovative medical products and services to the healthcare industry...
  • 1 Month Ago

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0 Medical Policy Specialist jobs found in Bethlehem, PA area

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Director, Medical Science Liaisons
  • Iecure Inc.
  • Blue Bell, PA
  • The Director of Medical Science Liaisons (MSL)will report directly to the VP, Therapeutic Area Lead and be responsible f...
  • 4/28/2024 12:00:00 AM

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Lead HVAC Installer / Service Technician
  • Heating + Air Paramedics
  • Bethlehem, PA
  • Benefits: 401(k) 401(k) matching Dental insurance Free uniforms Health insurance Opportunity for advancement Paid time o...
  • 4/28/2024 12:00:00 AM

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Specialist, Electronics & Specialty Products
  • Messer Americas
  • Bethlehem, PA
  • Lead the workflow process that supports the Electronics and Specialty Products group in day-to-day operations for Bulk a...
  • 4/27/2024 12:00:00 AM

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Distribution Systems Analyst
  • Messer Americas
  • Bethlehem, PA
  • Job Summary As a key member of the Distribution Systems team, the Distribution Systems Analyst II plays a critical role ...
  • 4/27/2024 12:00:00 AM

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Licensed Practical Nurse (LPN)
  • A-Line Staffing Solutions
  • Spring City, PA
  • Job Description Job Description A-Line Staffing is now hiring Licensed Practical Nurse (LPN) in Spring City, PA 15206 .I...
  • 4/26/2024 12:00:00 AM

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Pharmacy Technician
  • A-Line Staffing Solutions
  • Horsham, PA
  • Job Description Job Description A-Line Staffing is now hiring Pharmacy Technician in Horsham PA 19044. If you are intere...
  • 4/26/2024 12:00:00 AM

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Lead Field Medical Director
  • iECURE, inc.
  • Blue Bell, PA
  • The Lead Field Medical Director will report directly to the VP, Therapeutic Area Lead and be responsible for developing ...
  • 4/25/2024 12:00:00 AM

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Family Nurse Practitioner
  • Sayre Health Center
  • Philadelphia, PA
  • Job Description Job Description Family Nurse Practitioner Sayre Health Center – Philadelphia, PA Job description We are ...
  • 4/25/2024 12:00:00 AM

Bethlehem is a city in Lehigh and Northampton counties in the Lehigh Valley region of the eastern portion of the U.S. state of Pennsylvania. As of the 2010 census, the city had a total population of 74,982, making it the seventh largest city in Pennsylvania, after Philadelphia, Pittsburgh, Allentown, Erie, Reading, and Scranton. Of this, 55,639 were in Northampton County, and 19,343 were in Lehigh County. Bethlehem lies in the center of the Lehigh Valley, a region of 731 sq mi (1,890 km2) that is home to more than 800,000 people. Together with Allentown and Easton, the Valley embraces the All...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$90,160 to $110,056
Bethlehem, Pennsylvania area prices
were up 1.5% 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