Medical Policy Specialist jobs in Bloomington, IL
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)
Recently Added Medical Policy Specialist jobs
Medical Billing Specialist
- Keplr Vision
-
Bloomington, IL
FULL_TIME
- Summary/Objective The Medical Billing Specialist is responsible for timely and accurate billing of all medical claims for a vision care practice. This position requires working with insurance companies, creating and submitting insurance claims, processing insurance claims, and any necessary follow-up work for rejected claims. Additional responsibilities include A/R, collections, and the revision of claims in third-party databases as necessary to secure payment. Primary Function Ensure timely and accurate submission of claims Ensure proper coding and filing of all Medical claims Review of Medicare B, and Medicare Secondary Payer claims for accuracy and timely submission per Medicare, Commercial, and Medicaid billing guidelines As Medicare payment occurs, identify and submit billing for secondary claims that do not automatically crossover to secondary insurance Monitor, and follow-up on unpaid claims Monitoring and managing all denied and rejected Medical claims for proper corrections and refiling Ensure rejected bills are corrected and resubmitted Accurately prepare, maintain and monitor practice specific MIPs reporting Minimum Qualifications/Requirements Minimum of three years of billing experience working with commercial insurance/Medicaid/Medicare required. CPT/ICD 10 coding experience required; certification preferred. Computer Skills: 3 years (Required) medical billing: 3 years (Required) CPT/ICD 10 Coding: 1 year (Preferred)
- 5 Days Ago
Medical Coder/Billing Specialist
- Jody L. Kelly, M.D. & Associates
-
Peoria, IL
FULL_TIME
- Jody L. Kelly, M.D. & Associates is looking for a Medical Coder/Billing Specialist The position is a four/five day work week Job qualifications: Education and experience required 3 to 5 years experien...
- 5 Days Ago
IT Helpdesk Specialist
- Hopedale Medical Complex
-
Hopedale, IL
FULL_TIME
- IT Helpdesk Specialist The IT Help Desk Specialist provides fast and effective support to our clients. As a Help Desk Specialist, you will be required to respond to queries in person and over the phon...
- 1 Month Ago
Patient Care Technician - Gastroenterology * Days - 20hrs/wk
- umhealthwest
-
Wyoming, MI
FULL_TIME
- Patient Care Technician - Gastroenterology * Days - 20hrs/wk Requisition #: req7677 Shift: Days FTE status: 0.5 On-call: No Weekends: No General Summary: Under the direction of a Provider (Physician o...
- 1 Month Ago
Medical Insurance Specialist (UICOMP-Medical Billing)
- University of Illinois
-
Peoria, IL
FULL_TIME
- Medical Insurance Specialist (UICOMP-Medical Billing) Hiring Department: Medical Billing Location: Peoria, IL USA Requisition ID: 1024065 Posting Close Date: 3/21/2024 This position is located on the ...
- 1 Month Ago
Policy Service Rep I
- Pekin Insurance
-
Pekin, IL
FULL_TIME
- You spend at least a third of your day at your job. You might as well spend it doing something you really love while working with a team you really enjoy being with, right? That’s the kind of atmosphe...
- 2 Days Ago
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0 Medical Policy Specialist jobs found in Bloomington, IL area
FT Data Entry Specialist - Work From Home>
- Sharecare
-
Bloomington, IL
- [Administrative Assistant / Remote] - Anywhere in U.S. / Competitive pay - As a Data Entry Specialist you'll: Access var...
- 4/30/2024 12:00:00 AM
Shipping and Receiving - Warehouse Associate / Delivery Driver
- DH Pace Company, Inc.
-
Bloomington, IL
- DH Pace Company, Inc. is seeking to hire a reliable and responsible Warehouse / Delivery Driver in Bloomington, IL! This...
- 4/29/2024 12:00:00 AM
Dental Hygienist
- Hiring Now!
-
Bloomington, IL
- Dental Hygienist Bloomington, IL As an elite clinical provider and patient advocate at Dental Group of Bloomington & Her...
- 4/29/2024 12:00:00 AM
Administrative Specialist III - Circuit Clerk Traffic Division
- McLean County, IL
-
Bloomington, IL
- Position Announcement Administrative Specialist III - Circuit Clerk's Traffic Division Starting Hourly Rate: $19.66/hr P...
- 4/28/2024 12:00:00 AM
Brand Sales Specialist- Information Architecture
- IBM
-
Bloomington, IL
- Introduction At IBM, work is more than a job - it's a calling: To build. To design. To code. To consult. To think along ...
- 4/27/2024 12:00:00 AM
Dental Nurse (Hygienist) - FT/PT
- Hiring Now!
-
Bloomington, IL
- Dental Hygienist Bloomington, IL As an elite clinical provider and patient advocate at Dental Group of Bloomington & Her...
- 4/27/2024 12:00:00 AM
Licensed Dental Hygienist - FT/PT
- Hiring Now!
-
Bloomington, IL
- Dental Hygienist Bloomington, IL As an elite clinical provider and patient advocate at Dental Group of Bloomington & Her...
- 4/27/2024 12:00:00 AM
EMT
- Hiring Now!
-
Peoria, IL
- Would you like to join an international team working to improve the future of healthcare? Do you want to enhance the liv...
- 4/26/2024 12:00:00 AM
About Bloomington, Illinois
Bloomington is a city in and the county seat of McLean County, Illinois, United States. It is adjacent to Normal, and is the more populous of the two principal municipalities of the Bloomington-Normal metropolitan area.
The 2010 Census showed the city had a population of 76,610, making it the 12th most populated city in Illinois, and the fifth-most populous city in the state outside the Chicago Metropolitan Area. Combined with Normal, the twin cities have a population of roughly 130,000.
Bloomington is located at 40°29′03″N 88°59′37″W. The city is at an elevation of 797 feet (243 m) above sea ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$85,891 to $104,839
Bloomington, Illinois area prices
were up 1.3% from a year ago
were up 1.3% from a year ago
What does a Medical Policy Specialist do?
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