Medical Policy Specialist jobs in Charleston, SC

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

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Medical Billing Specialists
  • Coastal Fertility Specialist
  • Charleston, SC FULL_TIME
  • Coastal Fertility Specialists (CFS) consists of 5 clinical and 2 administrative offices and over 110 employees including RN's, NP's, 5 physicians, and a complete embryology team all driven to be the best Reproductive Endocrinology practice in the southeast! We have won 3 consecutive national patient satisfaction awards and have pregnancy rates in the top 10% of the country. We pride ourselves in employee satisfaction!

    CFS is growing and has an immediate opening for a Medical Billing Specialist. This is a full-time position of approximately 40 hours per week and is based out of our North Charleston office (Ashley Phosphate).

    In this role duties will include:
    • Posting daily charges into practice's billing software. Charges must be entered within 3 days for non-cycle charges and within 6 days for cycle charges.
    • Daily balancing and processing of claims
    • Following up with insurance companies regarding claim submissions and payments
    • Answering patient questions regarding their billing statements
    • Transmitting electronic claims through the Clearinghouse
    • Collections
    • Accounts Receivable
    • General understanding of ICD-10 & CPT coding experience is required; working knowledge of Allscripts Practice Management software is preferred.
    CFS offers a competitive salary and full benefits including health and dental insurance, life insurance, disability insurance, a 401K retirement plan and annual bonuses based on the quality of patient care. The salary is commensurate with experience and qualifications.

    For more information about our practice please visit our website at www.coastalfertilityspecialists.com.
  • 1 Month Ago
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Medical Collections Specialist
  • Trident Medical Center
  • Charleston, SC FULL_TIME
  • THIS IS A WORK FROM HOME POSITION SCHEDULE REQUIRES 1 Saturday per month and 1 Evening per week(up to 9:00 PM). Introduction Do you have the career opportunities as a Medical Collections Specialist yo...
  • 17 Days Ago
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Medical Records Specialist
  • Trident Medical Center
  • Charleston, SC FULL_TIME
  • Introduction Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a(an...
  • 1 Month Ago
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Insurance Verification/Prior Authorization Specialist
  • Coastal Fertility Specialist
  • Daniel, SC FULL_TIME
  • Start a rewarding career that will last a lifetime! Coastal Fertility Specialists is growing and has an immediate opening for a Financial Counselor Assistant (Insurance Verification/Prior Authorizatio...
  • 1 Month Ago
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Front Desk Coordinator
  • Coastal Fertility Specialist
  • Mount Pleasant, SC FULL_TIME
  • Start a rewarding career that will last a lifetime! Coastal Fertility Specialists is growing and has an immediate opening for a Front Desk Coordinator (check out). We are looking for someone who wants...
  • 17 Days Ago
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Fertility Nurse Coordinator
  • Coastal Fertility Specialist
  • Mount Pleasant, SC FULL_TIME
  • Start a rewarding career that will last a lifetime! Coastal Fertility Specialists is growing and has an immediate opening for a Registered Nurse who wants to make a difference in this world by helping...
  • 17 Days Ago
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0 Medical Policy Specialist jobs found in Charleston, SC area

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Primary Care Physician
  • Teema
  • North Charleston, SC
  • Our client is seeking a Physician to provide direct primary medical care to patients and supervise medical care personne...
  • 4/26/2024 12:00:00 AM
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Echo Tech PRN Days
  • Tenet Health
  • Mount Pleasant, SC
  • Job Description Echo Tech PRN Days Position Summary Performs and monitors echocardiogram (cardiac ultrasound) procedures...
  • 4/26/2024 12:00:00 AM
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Medical Scribe for Southern Ortho & Sports Medicine
  • Tenet Health
  • Mount Pleasant, SC
  • Job Description General Summary: Follows physicians through his or her work day and chart patient encounters in real-tim...
  • 4/26/2024 12:00:00 AM
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Certified Medical Assistant for High Tide Internal Medicine
  • Tenet Health
  • Mount Pleasant, SC
  • Job Description $1000 Sign On Bonus Summary Medical office position responsible for providing direct nursing care in a m...
  • 4/26/2024 12:00:00 AM
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HVAC /Refrigeration Rack Service Technician
  • RSC Mechanical
  • Charleston, SC
  • RSC Mechanical, a thriving family-owned and family-run company, was born in the heart of Clinton Township, Michigan, and...
  • 4/26/2024 12:00:00 AM
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Travel Registered Nurse RN Case Manager
  • OneStaffMedical
  • CHARLESTON, SC
  • We. Are. OneStaff. Medical. An independently - owned, nationally - recognized and amazingly awesome staffing firm ready ...
  • 4/26/2024 12:00:00 AM
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Primary Care Physician
  • TEEMA
  • North Charleston, SC
  • Our client is seeking a Physician to provide direct primary medical care to patients and supervise medical care personne...
  • 4/25/2024 12:00:00 AM
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RN Manager of Utilization Review FT Days
  • Tenet Health
  • Mount Pleasant, SC
  • Job Description RN Case Manager Full Time Days Position Summary Facilitates and supports an effective Utilization Review...
  • 4/25/2024 12:00:00 AM
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About Charleston, South Carolina

Charleston is the oldest and largest city in the U.S. state of South Carolina, the county seat of Charleston County, and the principal city in the Charleston–North Charleston–Summerville Metropolitan Statistical Area. The city lies just south of the geographical midpoint of South Carolina's coastline and is located on Charleston Harbor, an inlet of the Atlantic Ocean formed by the confluence of the Ashley, Cooper, and Wando rivers. Charleston had an estimated population of 134,875 in 2017. The estimated population of the Charleston metropolitan area, comprising Berkeley, Charleston, and Dorche...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$84,972 to $103,723
Charleston, South Carolina area prices
were up 1.5% from a year ago
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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