Medical Policy Specialist jobs in Montana

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)

T
Paralegal - Contract & Policy Specialist
  • The Staff Pad
  • Helena, MT FULL_TIME
  • The Staff Pad is seeking a Paralegal - Contract and Policy Specialist. We are honored to partnered with a non-profit healthcare system in Helena, Montana with superior care and a hometown commitment to be the gold standard for health care in Montana.

    The Paralegal will provide legal support to the legal department of a hospital in Helena, Montana. This individual will assist in various legal matters related to healthcare operations, regulatory compliance, risk management, and litigation. The paralegal will work closely with attorneys, healthcare professionals, and administrative staff to ensure legal compliance and mitigate legal risks.

    Responsibilities:
    • Legal Research:Conduct legal research on healthcare regulations, statutes, and case law relevant to hospital operations.
    • Document Preparation:Draft and review legal documents, including contracts, agreements, policies, and correspondence.
    • Litigation Support: Assist in preparing legal documents for litigation, including discovery requests, pleadings, and motions.
    • Regulatory Compliance: Monitor changes in healthcare laws and regulations and assist in ensuring hospital compliance.
    • Risk Management: Assist in identifying and assessing legal risks to the hospital and developing strategies to mitigate those risks.
    • Records Management: Maintain organized and updated legal files and documentation, including electronic and physical records.
    • Administrative Support: Provide administrative support to the legal department, including scheduling meetings, managing calendars, and coordinating communications.
    • Collaboration:Collaborate with other departments, such as compliance, human resources, and finance, to address legal issues affecting hospital operations.
    • Confidentiality: Handle confidential information with discretion and maintain confidentiality of sensitive legal matters.


    Requirements

    Qualifications:
    • Education: Bachelor's degree in Paralegal Studies, Legal Studies, or related field preferred.
    • Experience:5 years experience as a paralegal, contract administration, document control specialist or similar capacity
    • License/Certification/Registry: Paralegal certificate preferred.


    Benefits

    - Competitive salary
    - Health, dental, and vision insurance
    - Retirement savings plan
    - Paid time off
    - Continuing education opportunities

  • 1 Month Ago

S
Contract and Policy Specialist 1.0 FTE 7135.654
  • SPH Careers
  • Helena, MT FULL_TIME
  • JOB SUMMARY (overview of job): The Contract and Policy Specialist is responsible for ensuring consistent management of system-wide documents, such as contracts, policies and forms. This position will ...
  • 1 Month Ago

A
Merchandiser (2023-32922)
  • Apollo Retail Specialist
  • Montana City, MT PART_TIME
  • As a merchandiser, you’ll take on project-based work to ensure products and displays are visually appealing to attract and engage shoppers, build strong relationships with store managers, ensure the r...
  • Just Posted

M
Policy Director
  • Montana Grain Growers Association
  • Great Falls, MT PART_TIME
  • About us The Montana Grain Growers Association is a commodity specific organization representing the interests of Montana wheat and barley growers. We use the contacts and experience gained over the p...
  • 26 Days Ago

C
Plant Ops - Construction Building Specialist
  • Community Medical
  • Missoula, MT FULL_TIME
  • This is a full time (0.8 - 1.0 Status), day shift Construction Building Specialist position in the Plant Ops department. Manages building program. Maintains, services, and conducts minor repairs on bu...
  • 1 Month Ago

C
CPG Physical Medicine & Rehab - Clinical Service Specialist
  • Community Medical
  • Missoula, MT PART_TIME
  • This is a TPD (0.2 Status), day shift Clinical Service Specialist position in the CPG Physical Medicine & Rehab clinic. The Clinical Service Specialist is a dynamic caregiver who demonstrates excellen...
  • 1 Month Ago

N
Medical Assistant/ Medication Specialist
  • Nidraveda PA
  • San Antonio, TX
  • Job Description Job Description We are looking for someone with a professional attitude, a dedication to healthcare, and...
  • 4/25/2024 12:00:00 AM

P
Medical Specialist
  • PSG Global Solutions Careers
  • South San Francisco, CA
  • Apply now and our proprietary system will quickly have you in front of a live recruiter. The Opportunity Description We'...
  • 4/24/2024 12:00:00 AM

R
Medical Specialist I (Gastro)-Greenville, SC
  • Regeneron Pharmaceuticals
  • Columbia, SC
  • The Medical Specialist (Sales Representative), Gastroenterology (MS) will report to the District Manager, Gastroenterolo...
  • 4/24/2024 12:00:00 AM

S
Medical Specialist 1
  • StateJobsNY
  • Tupper Lake, NY
  • Minimum Qualifications: Open Competitive: Possession of a license and current registration to practice medicine in New Y...
  • 4/23/2024 12:00:00 AM

U
Medical Assistant, Medical Specialists
  • UP Health System - Marquette
  • Marquette, MI
  • UP Health System - Marquette Medical Assistant, Medical Specialists, 1.0DV Who We Are: People are our passion and purpos...
  • 4/22/2024 12:00:00 AM

O
(Physician) Medical Specialist 2
  • Office for People with Developmental Disabilities
  • Thiells, NY
  • Job Description Job Description EMPLOYMENT OPPORTUNITY ANNOUNCEMENT EOA #: 23-061RR EOA DATE: March 15, 2024 REPLY BY: S...
  • 4/22/2024 12:00:00 AM

U
Medical Specialist
  • U.S. Air Force Reserve
  • Position Summary Our hundreds of medical facilities around the world are only as good as the staff who run them. Providi...
  • 4/21/2024 12:00:00 AM

H
Inventory Medical Specialist - Materials Services OR
  • Hoag Memorial Hospital Presbyterian
  • ** Inventory Medical Specialist - Materials Services OR** Department: Support Services Status: Full Time Shift: 1st **Pr...
  • 4/21/2024 12:00:00 AM

Montana (/mɒnˈtænə/ (listen)) is a landlocked state in the Northwestern United States. Montana has several nicknames, although none are official, including "Big Sky Country" and "The Treasure State", and slogans that include "Land of the Shining Mountains" and more recently "The Last Best Place". Montana is the 4th largest in area, the 8th least populous, and the 3rd least densely populated of the 50 U.S. states. The western half of Montana contains numerous mountain ranges. Smaller island ranges are found throughout the state. In all, 77 named ranges are part of the Rocky Mountains. The easte...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$83,541 to $101,976

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