Medical Policy Specialist jobs in Iowa

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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Policy Quality Control Specialist
  • EquiTrust
  • Des Moines, IA FULL_TIME
  • The Policy Quality Control Specialist works collaboratively with team members, as well as independently, to accomplish their daily tasks and duties, with the ultimate goal of providing excellent customer service. This individual will review and ensure accuracy on client life and/or annuity policies, as well as, work with the New Business department to complete the necessary corrections. The Policy Quality Control Specialist is expected to communicate effectively, resolve issues as they arise and prioritize workflows and tasks to accomplish daily duties.

    Essential Duties and Responsibilities:

     

    • Responds to agent, independent marketing organization and policy holder inquiries by clarifying desired information, researching, locating and providing follow up responses.
    • Accurately updates and maintains records of all conversations and transactions in the call center database.
    • Meets job specific quantitative and qualitative performance standards and metrics.
    • Uses Quality Control sheets and various systems to review customer’s life and annuity policies prior to mailing to ensure accuracy.
    • Communicates with New Business department as need to have errors corrected.
    • Assists with follow-up letters to agents and clients including delivery receipts, amendments and illustrations.
    • Supports the Policy Administration team and other departments on an as needed basis.
    • Willingly takes on additional responsibilities as requested in order to accomplish department and Company objectives.
    • Actively participates and contributes to the goals and objectives of the Company by working collaboratively and fostering a positive and inclusive work environment.

    Skills and Abilities: 

    • Ability to learn and retain a large amount of detailed information regarding EquiTrust’s life and annuity products.
    • Must have basic mathematical, organizational, and problem-solving skills and attention to detail.
    • Must be able to communicate effectively using verbal and written methods.
    • Ability to prioritize workflows, establish and meet deadlines and manage multiple concurrent tasks.
    • Ability to work effectively in a variety of situations and respond to change in a positive manner.
    • Basic computer skills and the ability to navigate multiple systems and programs including Microsoft Office, proprietary systems, and other technology solutions.
    • Ability to meet attendance and punctuality standards.
    • Carries out responsibilities in a manner that is consistent with EquiTrust’s Core Values and focus on customer service; helps to create an environment of openness and trust for all employees and strives for continued professional skills development.

    Training or Work Experience: 

    • Minimum 1 year of experience in a general office environment preferred.
    • 1 year of life and annuity experience preferred.

    Education: 

    • High School Diploma or Equivalent preferred.

    Working Conditions: 

    • On-Site Location: West Des Moines, Iowa - Hybrid.
    • Business Travel: Travel not required/likely.

    #LI-HYBRID 

    #LI-JG1

    EquiTrust is an Equal Opportunity Employer and participates in the U.S. Federal E-Verify program. Applicants have rights under federal and state employment laws. To learn more, visit https://www.equitrust.com/careers/opportunities/federal-and-state-employment-laws/.  

  • 1 Month Ago

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Commercial Private Insurance Policy Review Specialist
  • Wells Fargo
  • DES MOINES, IA FULL_TIME
  • About this role:Wells Fargo is seeking a Commercial Private Insurance Policy Review Specialist within Wholesale Lending Flood Operations.This role will provide subject matter expertise to external reg...
  • 14 Days Ago

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Medical Billing Specialist
  • YourTIME Medical
  • Falls, IA PART_TIME
  • Job Summary: We are seeking a skilled and detail-oriented Medical Biller to join our team. As a Medical Biller, you will be responsible for accurately coding and billing medical procedures and service...
  • 3 Days Ago

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Dental Assistant
  • Dental Specialist
  • Ankeny, IA FULL_TIME
  • Overview:We are seeking a skilled and compassionate Dental Assistant to join our team. As a Dental Assistant, you will play a crucial role in providing quality dental care to our patients. Your primar...
  • 9 Days Ago

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Veterinary Medical Officer (Veterinary Biologics Science and Policy Advisor)
  • US Animal and Plant Health Inspection Service
  • Ames, IA FULL_TIME
  • Duties The duties may include, but are not limited to: Provides scientific and technical guidance in the management of formulating, organizing, and executing veterinary biologics regulations and polic...
  • 9 Days Ago

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Medical Office Specialist
  • Cedar Valley Medical Specialists PC
  • Cedar, IA FULL_TIME
  • DescriptionCVMS Orthopedic Clinic located on the campus of University of Northern Iowa is looking for a driven front desk specialist to help serve patients in the clinic. Primary job responsibilities ...
  • 21 Days Ago

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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'...
  • 4/19/2024 12:00:00 AM

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Medical Specialist I
  • Regeneron Pharmaceuticals
  • Orange, CA
  • The Medical Specialist (Sales Representative), Allergy-ENT will report to the District Manager, Allergy-ENT and be respo...
  • 4/19/2024 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...
  • 4/19/2024 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...
  • 4/18/2024 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...
  • 4/17/2024 12:00:00 AM

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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...
  • 4/16/2024 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...
  • 4/16/2024 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...
  • 4/15/2024 12:00:00 AM

Iowa (/ˈaɪəwə/ (listen)) is a state in the Midwestern United States, bordered by the Mississippi River to the east and the Missouri River and Big Sioux River to the west. It is bordered by six states; Wisconsin to the northeast, Illinois to the east, Missouri to the south, Nebraska to the west, South Dakota to the northwest and Minnesota to the north. In colonial times, Iowa was a part of French Louisiana and Spanish Louisiana; its state flag is patterned after the flag of France. After the Louisiana Purchase, people laid the foundation for an agriculture-based economy in the heart of the Corn...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$85,598 to $104,487

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