Medical Policy Specialist jobs in Lincoln, NE

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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Medical Billing Specialist
  • Saunders Medical Center
  • Wahoo, NE FULL_TIME
  • You may apply online—it's quick and easy. Just click on the button!

    • You can also email us at JoinOurTeam@smcne.com or call (402) 443-1409.
    • SMC will only accept applications for positions that are posted.

    Help Wanted | Positions Available

    Click each job below for details.

    • Registration Tech

      Full-Time

    • Housekeeping Tech

      Full-time or Part-time

    • Dietary Aide

      Kitchen | PRN Evenings

    • Hospital RN

      Days & Nights PRN

    • Hospital RN

      Full-time and Part-time Nights
      ***HIRING BONUS***

    • Radiologic Technologist

      PRN

    • Medical Laboratory Technician (MLT/MT/MLS)
    • Medical Billing Specialist

      Full-time

      Medical Billing Specialist

      Full-Time 8:am-4:30 Monday- Friday

      SUMMARY

      Perform daily business operations tasks and support hospital and clinic billing procedures with accuracy and timeliness.

      ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and /or ability required.

      Prepare hospital and clinic charges for entry and ensure all charges are accounted for and accurate.

      Data entry, posting payments, preparing deposits, reconciling billings, claims submissions, checking balances, accounts payable and maintaining patient records.

      Support daily postings and end of month closings.

      Audit accounts and charges to ensure accuracy, prepare QA reports.

      Answer inquiries from patients regarding account charges, insurance payments and balances due.

      Works with third party payers/patients to assure timely payment on accounts.

      Assist with special projects as assigned.

      Back up other positions within department when vacations, medical leave, absences, etc. occurs.

      Maintain skills/competencies required for this position.

      Participate in all safety, security and infection control programs that are mandatory as well as those required and provided by the department.

      Uphold confidentiality and HIPAA compliance at all times and report violations to the Privacy Officer.

      Understand and comply with the requirements of the Saunders Medical Center’s Compliance Program, including, but not limited to the Code of Conduct, the Compliance Policy, all Saunders Medical Center-wide policies for compliance, and compliance plans affecting specific duties and responsibilities.

      Participate in all education and training programs regarding compliance as required by Saunders Medical Center policy and as requested by the Supervisor.

      Demonstrate personal traits of a high-level commitment, motivation and energy; team orientation; professionalism; trust; personal honesty and integrity; and a demonstration of placing others in a place of high value and treating them with dignity and respect.

      Other duties as assigned by the Supervisor.

      SUPERVISORY RESPONSIBILITIES

      This position has no supervisory responsibility.

      DISCLOSURE STATEMENT
      The above statements reflect the general details considered necessary to describe the essential functions of the job as identified, and shall not be considered as a detailed description of all work requirements that may be inherent in the position.

      EDUCATION and/or EXPERIENCE

      High school education or equivalent. Prior hospital/clinic billing experience preferred.

      CERTIFICATES, LICENSES, REGISTRATIONS

      None required.

      LANGUAGE SKILLS

      Must be able to read, write and follow written and oral instructions and possess positive skills in communication. Ability to deal tactfully with personnel, patients, visitors, and the general public.

      MATHEMATICAL SKILLS

      Ability to calculate at the level necessary to perform essential duties of the position.

      REASONING ABILITY

      Ability to make independent decisions when circumstances warrant such action. Ability to interpret a variety of instructions furnished in oral, written, diagram or schedule form.

      PHYSICAL DEMANDS

      The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

      While performing the duties of this job, the employee must regularly sit. The employee must be able to stand, reach with hands and arms and may occasionally be requir3ed to lift up to 25 pounds.

      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 of this position. Attendance is essential and required for a successful working environment.

      Click Here to Apply!

    • HIM Technician II

      Full-time

    • Clinic Certified Medical Assistant

      PRN

    • Hospital LPN

      ***HIRING BONUS***
      FT and PT Nights

    • Hospital LPN-PRN

      PRN

    Nursing Home | Long Term Care Positions

    Shift Times Days 6 am-2:30 pm, Evenings 2-10:30 pm, Nights 10 pm-6:30 am

    • RN/LPN

      Full-time-Days
      Bonus Available!

    • RN

      Part-time-Days, Evenings, and Nights
      Bonus Available!

    • Nursing Assistant (CNA)

      Full-time & Part-time Days, Evenings & Nights!
      Bonus Available!

    • Nursing Assistant (CNA) PRN

      Long term care PRN CNA

    • Medication Aide

      PRN

    • LPN

      Part-time & Full-Time
      Days, Evenings, and Nights
      Bonus Available!

    • Charge NurseLTC RN/LPN

    Superb Benefits | One Team

    EQUAL OPPORTUNITY EMPLOYER

    All positions offer:

    • Competitive salary and benefits
    • Health Insurance with HSA contribution
    • Health Coach Services
    • Dental and Vision Insurance with SMC contribution
    • Short and Long Term Disability; premiums paid by SMC
    • Life and AD&D for Employee and Dependents paid by SMC
    • PTO, Bereavement, and Holiday pay
    • One America retirement with SMC Contribution
    • Shift and weekend differentials & Call Pay
    • Dependent Care and Medical Flexible spending
    • Student Internship Program
    • Workforce Connections Program, Continuing Education Opportunities, & Tuition Reimbursement, NHA Leadership Institute
    • CPR Training
    • Medical Bill Payroll Deduction Program
    • RX Discount Program
    • Professional License Renewal
    • Free Immunizations
    • Discounted meals
    • Employee Assistance Program
    • Emergency Employee Assistance Fund
    • Anniversary Service Recognition packages
    • Personal Training and Access to Fitness Center
    • Premier Purchasing Group Discounts
    • Employee Referral Bonus
    • Further discounts including: EDGE Workouts, Specific lab draws, Verizon Wireless, and more!

    We look forward to the contributions you can make to our staff, our patients and our community!

  • 8 Days Ago

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Communications Director
  • OpenSky Policy Institute
  • Lincoln, NE FULL_TIME
  • OpenSky Policy Institute is seeking a Communications Director to carry our message through strategic communications, media relations, and digital strategy to achieve our mission. The Communications Di...
  • Just Posted

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Operations Specialist
  • York Medical Clinic
  • Exeter, NE FULL_TIME
  • Hourly, Full-Time Position Salary range is estimate based on potential overtime hours and may varyDo something different every day as you work with our agronomy department and their many services. You...
  • 23 Days Ago

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Billing Specialist
  • Saunders Medical Center
  • Wahoo, NE FULL_TIME
  • Billing SpecialistJob Title Billing SpecialistReports To Business Office ManagerDepartment Business OperationsFLSA Status Non-ExemptSummaryPerform daily business operations tasks and support hospital ...
  • 24 Days Ago

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Medical Billing Specialist
  • Gastroenterology Specialties, PC
  • Lincoln, NE FULL_TIME
  • We are a busy gastroenterology office with 31 Providers. We are looking for a team-oriented individual to help us provide great care to our patients! This individual should show great attention to det...
  • 10 Days Ago

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Medical Billing Specialist
  • Mid-Plains Center for Behavioral Healthcare Services, Inc.
  • Grand Island, NE FULL_TIME
  • We are seeking a detail-oriented and experienced Medical Billing Specialist to join our Finance Team. The ideal candidate will have a strong background in medical billing procedures and insurance proc...
  • 5 Days Ago

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0 Medical Policy Specialist jobs found in Lincoln, NE area

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Physical Therapist - Travel Contract
  • Jackson Therapy Partners
  • Lincoln, NE
  • We're seeking a full time Physical Therapist to provide expert physical therapy to patients with injuries or illnesses t...
  • 4/18/2024 12:00:00 AM

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LPN or RN
  • Grifols
  • Lincoln, NE
  • Would you like to join an international team working to improve the future of healthcare? Do you want to enhance the liv...
  • 4/17/2024 12:00:00 AM

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RN
  • Hiring Now!
  • Lincoln, NE
  • Would you like to join an international team working to improve the future of healthcare? Do you want to enhance the liv...
  • 4/17/2024 12:00:00 AM

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Onsite AV Support Technician II
  • AVI-SPL
  • Lincoln, NE
  • WHO WE ARE AVI-SPL is a digital enablement solutions provider who transforms how people and technology connect to elevat...
  • 4/17/2024 12:00:00 AM

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Consumer Direct Sales
  • Windstream
  • Lincoln, NE
  • About Us: Windstream is a leading provider of advanced network communications and technology solutions for consumers, sm...
  • 4/17/2024 12:00:00 AM

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Registered Nurse
  • Hiring Now!
  • Lincoln, NE
  • Would you like to join an international team working to improve the future of healthcare? Do you want to enhance the liv...
  • 4/14/2024 12:00:00 AM

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RN
  • Grifols
  • Lincoln, NE
  • Would you like to join an international team working to improve the future of healthcare? Do you want to enhance the liv...
  • 4/13/2024 12:00:00 AM

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Certified Medication Aide
  • Mosaic
  • Beatrice, NE
  • Schedule: Full-Time Days, Evenings, Overnights On-Call If making a positive impact in the lives of others is always on y...
  • 4/12/2024 12:00:00 AM

Lincoln is the capital of the U.S. state of Nebraska and the county seat of Lancaster County. The city covers 94.267 square miles (244.150 km2) with a population of 284,736 in 2017. It is the second-most populous city in Nebraska and the 71st-largest in the United States. The city is the economic and cultural anchor of a substantially larger metropolitan area in the southeastern part of the state called the Lincoln Metropolitan and Lincoln-Beatrice Combined Statistical Areas. The statistical area is home to 353,120 people, making it the 106th-largest combined statistical area in the United ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$83,452 to $101,867
Lincoln, Nebraska area prices
were up 0.8% 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