How much does a Medical Policy Specialist make in the United States? The average Medical Policy Specialist salary in the United States is $92,581 as of January 26, 2024, but the range typically falls between $84,444 and $99,707. Salary ranges can vary widely depending on many important factors, including education, certifications, additional skills, the number of years you have spent in your profession. With more online, real-time compensation data than any other website, helps you determine your exact pay target. 

Medical Policy Specialist Salaries by Percentile
Percentile Salary Location Last Updated
10th Percentile Medical Policy Specialist Salary $77,035 US January 26, 2024
25th Percentile Medical Policy Specialist Salary $84,444 US January 26, 2024
50th Percentile Medical Policy Specialist Salary $92,581 US January 26, 2024
75th Percentile Medical Policy Specialist Salary $99,707 US January 26, 2024
90th Percentile Medical Policy Specialist Salary $106,194 US January 26, 2024
25% $84,444 10% $77,035 90% $106,194 75% $99,707 $92,581 50%(Median) Didn’t find job title? Click
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Check out Medical Policy Specialist jobs in Ashburn, Virginia

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Job Description for Medical Policy Specialist

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 View full job description

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Career Path for Medical Policy Specialist

A career path is a sequence of jobs that leads to your short- and long-term career goals. Some follow a linear career path within one field, while others change fields periodically to achieve career or personal goals.

For Medical Policy Specialist, the first career path typically progresses to Staff Nurse - RN, Sr. - Medical Management.

The second career path typically progresses to Medical Policy Manager.

The third career path typically progresses to Top Provider Network Executive.

Additionally, the fourth career path typically progresses to Reimbursement Services Director.

Those that have already made the climb...
Patrick J. Haveron, Co-Chief Executive Officer and Chief Financial Officer
Maiden Holdings, Ltd., through its subsidiaries, provides property and casualty reinsurance solutions to regional and specialty insurers in Europe, the United States, and internationally. It operates in two segments, Diversified Reinsurance and AmTrust Reinsurance. The company writes treaties on a quota share basis and... More
Fiscal Year Ended in 2022
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Medical Policy Specialist salary varies from city to city. Compared with national average salary of Medical Policy Specialist, the highest Medical Policy Specialist salary is in San Francisco, CA, where the Medical Policy Specialist salary is 25.0% above. The lowest Medical Policy Specialist salary is in Miami, FL, where the Medical Policy Specialist salary is 2.9% lower than national average salary.

City, State Compared to national average
City, State San Francisco, CA Compared to national average
+ 25.0%
City, State Washington, DC Compared to national average
+ 11.3%
City, State Miami, FL Compared to national average
City, State Chicago, IL Compared to national average
+ 5.5%
City, State Boston, MA Compared to national average
+ 12.7%
City, State New York, NY Compared to national average
+ 17.5%
City, State Dallas, TX Compared to national average

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These charts show the average base salary (core compensation), as well as the average total cash compensation for the job of Medical Policy Specialist in the United States. The base salary for Medical Policy Specialist ranges from $84,444 to $99,707 with the average base salary of $92,581. The total cash compensation, which includes base, and annual incentives, can vary anywhere from $89,050 to $108,698 with the average total cash compensation of $99,751.
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Skills associated with Medical Policy Specialist: Medical Policy Management, Utilization Management

Jobs with a similar salary range to Medical Policy Specialist : IT Process Manager

Salary estimation for Medical Policy Specialist at companies like : Pancheros of Ct, The Bradco Companies, The East Syracuse-Minoa Central School District

Medical Policy Specialist Salary in United States
Medical Policy Specialist Salary Graph, Regional Distribution and Summary