Medical Policy Specialist jobs in Tennessee

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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Risk and Policy Specialist
  • Ncontracts
  • Brentwood, TN FULL_TIME
  • Risk and Policy Specialist
    Remote | Product and Development | Full-Time

    WHO WE ARE

    Ncontracts provides comprehensive vendor, compliance, risk management, and lending compliance solutions to a rapidly expanding customer base of over 4,000 financial institutions in the United States. We help financial institutions achieve their compliance and risk management goals with a powerful combination of user-friendly, cloud-based software and expert services. Our solution suite encompasses the complete lifecycle of risk, including vendor management, enterprise risk management, business continuity, compliance, audit and findings management, and cybersecurity. The company was named to the Inc. 5000 fastest-growing private companies in America for the fifth consecutive year. For more information visit www.ncontracts.com or follow the company on LinkedIn and Twitter.
     

    THE ROLE   

    Ncontracts provides excellent compliance and risk support to thousands of financial institutions through its various risk and compliance solutions. This role will be responsible for creating, tracking, updating, and revising risk and policy-related content within Ncontracts’ solutions. 

    YOU WILL  

    • Create and deliver comprehensive, relevant, and accurate risk assessment content to our customers in a timely manner 

    • Generate institution-wide policies using established template 

    • Maintain and update existing risk assessments 

    • Maintain and update existing policies 

    • Identify industry developments to keep apprised of emerging and changing risks and enhance content 

    • Proactively communicate with other team members and company experts 

    • Gather and report product usage metrics 

    YOU BRING 

    • Ideal team player (humble, hungry, and smart) 

    • Risk-related experience developed at a financial institution, of creating or updating risk assessments 

    • Experience with creating or updating policies 

    • Strong written communication skills 

    • Thoughtful prioritization, organization, and time management 

    • Ability to work independently 

    • Strong research and documentation skills 

    • Attention to detail and accuracy 

    BONUS POINTS 

    • Certification(s) in risk-related topics (e.g. CERP, NCRM)  

    • Experience with using Ncontracts’ software 

    TRAVEL 

    • This position may require travel to meet with team members, attend training, and to represent Ncontracts at industry events.  

    WE OFFER

    • A fun, fast-paced work environment
    • Responsible PTO Plan that meets or exceeds state and local medical and family leave laws
    • 11 paid holidays
    • Community and social events to keep you connected and engaged
    • Mental Health Benefits
    • Medical, Dental and Vision insurance
    • Company-paid Group Life Insurance, Short- and Long-Term Disability
    • Flexible Spending Account & Health Savings Account
    • Aflac Benefits – Critical Illness, Cancer Protection, & Hospital Choice
    • Pet Insurance
    • 401 (k) with company match with eligibility on Day 1 of employment
    • 2 Paid Volunteer Time Off Days
    • And much more!
       

    Compensation Information

    Pursuant to state and local law disclosure requirements, the pay range for this role, with final offer amount dependent on education, skills, experience and location is $70,000 to $90,000 per year. This position may be eligible for an annual discretionary incentive award. The incentive award amount is dependent upon company performance and your personal performance and is not guaranteed.

    AAP/EEO Statement

    Ncontracts provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

    This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

    Other Duties

    Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

  • 22 Days Ago

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Policy Specialist - Dialer
  • Zander Insurance Agency
  • Nashville, TN FULL_TIME
  • In this role, you’ll help clients secure the protection they need by making outbound calls and guiding them through the last steps of the insurance process. This position provides an opportunity to en...
  • 1 Month Ago

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Supervisory IT Cybersecurity Specialist (Policy and Planning)
  • Navy MWR Key West
  • Millington, TN FULL_TIME
  • Summary This position is assigned to the Nonappropriated Fund Chief Information Officer N6, NAF System Branch N6Q; Commander, Navy Installation Command, Millington, TN. The incumbent is responsible fo...
  • 19 Days Ago

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Medical Records Specialist PRN
  • TriStar Centennial Medical Center
  • Nashville, TN FULL_TIME
  • Introduction Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a(an) Medical Records Specialist PRN with TriStar Centennial Medical Center you can...
  • 21 Days Ago

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Medical Records Specialist
  • TriStar NorthCrest Medical Center
  • Springfield, TN FULL_TIME
  • Introduction Are you looking for a work environment where diversity and inclusion thrive? Submit your application for our Medical Records Specialist opening with TriStar NorthCrest Medical Center toda...
  • 10 Days Ago

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Medical Device Specialist
  • B. Braun Medical Inc.
  • Nashville, TN 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...
  • 14 Days Ago

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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...
  • 4/26/2024 12:00:00 AM

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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...
  • 4/26/2024 12:00:00 AM

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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

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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

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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

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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

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(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

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RN-WMG-Endo Medical Specialist-Days
  • Wellstar Medical Specialists
  • Marietta, GA
  • Summary: Ambulatory/Outpatient refers to medical services performed on an outpatient basis, without admission to a hospi...
  • 4/22/2024 12:00:00 AM

Tennessee borders eight other states: Kentucky and Virginia to the north; North Carolina to the east; Georgia, Alabama, and Mississippi on the south; Arkansas and Missouri on the Mississippi River to the west. Tennessee is tied with Missouri as the state bordering the most other states. The state is trisected by the Tennessee River. The highest point in the state is Clingmans Dome at 6,643 feet (2,025 m). Clingmans Dome, which lies on Tennessee's eastern border, is the highest point on the Appalachian Trail, and is the third highest peak in the United States east of the Mississippi River. The ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$82,826 to $101,103

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