Medical Policy Specialist jobs in Kentucky
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)
Recently Added Medical Policy Specialist jobs
Medical Office Assistant - Scheduling Specialist - Surgical Specialist Owensboro
- Scheduling Specialist - Surgical Specialist Owensboro in Owensboro, KY - Owensboro
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Owensboro, KY
FULL_TIME
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Summary
Job Summary
Responsible for a variety of clinical and administrative tasks related to patient registration, assessments, and scheduling while maintaining confidentiality, professionalism, and a high level of ethical behavior. All tasks executed with emphasis on patient access and satisfaction, accuracy of information, and patient assistance.Job Responsibilities- Schedules and reschedules appointments and diagnostic testing using computerized scheduling programs as required.
- Collects and records vital signs.
- Performs basic diagnostic procedures and specimen collection.
- Monitors and communicates changes in patient condition.
- Documents patient care given.
- Maintains equipment and medical supplies, including reordering, stocking, cleaning, and troubleshooting.
- Accepts payments and co-pays and other fees for services during registration.
- May be required to reconcile co-payments and cash receipts at the end of shifts.
- Communicates effectively with insurance companies, external agencies, patients, physicians, and team members.
- May communicate with referring facilities regarding patient transfers.
- Arranges for hospital admissions as appropriate.
- Answers internal and external calls; takes requests for patient information, disperses the information with accountability to all regulatory entities and according to the facility's policies and procedures.
- Maintains examination areas.
- Performs patient registration, patient check-out, pre-certifications, pre-procedure instructions, and appointment confirmations.
- Retrieves records as requested by authorized persons. Ensures that properly executed release of information forms are obtained when necessary.
- Files new and returned records according to established systems and policies. Identifies and documents missing records.
- Enters information from a variety of sources into computer database(s). Verifies data entered into computer by checking printouts/reports for errors and correcting as required.
- Locates and prepares records for archival or destruction according to policies and procedures. Initiates retrieval and return of archived records and follows up on any delays or problems with retrieval.
- Assists with performing patient assessments and treatments under the supervision of a physician, nurse practitioner, physician assistant or nurse.
- Greets patients as they arrive into the facility and provides appropriate information.
- Prepares patients for medical procedures as appropriate.
Qualifications- High school diploma, General Equivalency Diploma (GED) or higher preferred
- No experience required
- ABR-OE - Credential from American Association of Medical Assistants (AAMA) required within 120 days of obtaining 24 months of experience within the last 36 months in a health care facility under the supervision of a licensed health care provider AND
- BLS - Certified as a Basic Life Support Healthcare Provider required within 90 days of employment in this position
Skills and Attributes- Requires critical thinking skills and decisive judgment.
- Works under minimal supervision.
- Must be able to work in a stressful environment and take appropriate action.
Physical Demands- Standing: Frequently
- Walking: Frequently
- Sitting: Occasionally
- Lifting 0-25 lbs: Rarely
- Lifting 25-75 lbs: Rarely
- Lifting over 75 lbs: Rarely
- Carrying 0-25 lbs: Rarely
- Carrying 25-75 lbs: Rarely
- Carrying over 75 lbs: Rarely
- Pushing/Pulling 0-25 lbs: Frequently
- Pushing/Pulling 25-75 lbs: Occasionally
- Pushing/Pulling over 75 lbs: Occasionally
- Climbing: Occasionally
- Bending/Stooping: Frequently
- Kneeling: Occasionally
- Crouching/Crawling: Occasionally
- Reaching: Frequently
- Talking: Frequently
- Hearing: Frequently
- Repetitive Foot/Leg Movements: Rarely
- Repetitive Hand/Arm Movements: Frequently
- Keyboard Data Entry: Frequently
- Running: Rarely
- Vision: Depth Perception: Frequently
- Vision: Distinguish Color: Frequently
- Vision: Seeing Far: Frequently
- Vision: Seeing Near: Frequently
Owensboro Health Core Commitments
INTEGRITY - We conduct ourselves with a high level of responsibility, reliability and honesty because we take seriously the trust of our patients and coworkers.
RESPECT - We value and accept the unique talents and contributions of every patient, customer and team member in the Owensboro Health community.
TEAMWORK - We build a spirit of connectivity and fellowship by striving together to overcome obstacles, surpass goals, celebrate accomplishments and plan the future.
INNOVATION - We foster original ideas and creative solutions that improve our daily work and promote the mission of Owensboro Health.
SERVICE - We focus on service to patients, customers and team members by anticipating their needs, thoughtfully meeting those needs and continually improving the quality of everything we do.
EXCELLENCE - We reach beyond basic expectations to expand our knowledge and awareness, produce exceptional work and provide outstanding service. - 15 Days Ago
Regulatory Strategy and Policy Specialist
- Four Rivers Nuclear Partnership LLC
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Paducah, KY
FULL_TIME
- Position OverviewUnder general supervision, performs environmental regulatory strategy and policy development job functions as assigned by management. Typical job responsibilities assist and support m...
- 16 Days Ago
IT Specialist (Policy and Planning)
- U.S. Army Cyber Command
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Fort Knox, KY
FULL_TIME
- Duties Responsible for project development and long-range planning for unclassified and classified network installation-wide Army Information technology Services catalog (AITSC) services... requiremen...
- 30 Days Ago
Health Policy Specialist II (FFTL)
- Commonwealth of Kentucky
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Frankfort, KY
FULL_TIME
- Advertisement Closes 7/20/2023 (7:00 PM EST) req52254 Health Policy Specialist II (FFTL) Pay Grade 15 Salary $59,079.36 - $62,033.52 Employment Type EXECUTIVE BRANCH | FULL TIME | ELIGIBLE FOR OVERTIM...
- 21 Days Ago
Health Policy Specialist II (FFTL)
- Kentucky Department Of Corrections
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Frankfort, KY
FULL_TIME
- Advertisement Closes 7/20/2023 (7:00 PM EST) req52254 Health Policy Specialist II (FFTL) Pay Grade 15 Salary $59,079.36 - $62,033.52 Employment Type EXECUTIVE BRANCH | FULL TIME | ELIGIBLE FOR OVERTIM...
- 21 Days Ago
Information Technology Specialist (Policy and Planning)
- U.S. Army Training and Doctrine Command
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Fort Knox, KY
FULL_TIME
- Duties Coordinating and integrating technical aspects of information technology with administrative matters. Perform acquisition planning; acquisition management; procures Information Technology resou...
- 21 Days Ago
Medical Policy Specialist jobs at Popular Companies
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
Medical Specialist
- PSG Global Solutions Careers
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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
Medical Specialist I (Gastro)-Greenville, SC
- Regeneron Pharmaceuticals
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Columbia, SC
- The Medical Specialist (Sales Representative), Gastroenterology (MS) will report to the District Manager, Gastroenterolo...
- 4/24/2024 12:00:00 AM
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
Medical Assistant, Medical Specialists
- UP Health System - Marquette
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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
(Physician) Medical Specialist 2
- Office for People with Developmental Disabilities
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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
Medical Specialist
- U.S. Air Force Reserve
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- 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
Inventory Medical Specialist - Materials Services OR
- Hoag Memorial Hospital Presbyterian
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- ** Inventory Medical Specialist - Materials Services OR** Department: Support Services Status: Full Time Shift: 1st **Pr...
- 4/21/2024 12:00:00 AM
About Kentucky
Kentucky (/kənˈtʌki/ (listen) kən-TUK-ee), officially the Commonwealth of Kentucky, is a state located in the east south-central region of the United States. Although styled as the "State of Kentucky" in the law creating it, (because in Kentucky's first constitution, the name state was used) Kentucky is one of four U.S. states constituted as a commonwealth (the others being Virginia, Pennsylvania, and Massachusetts). Originally a part of Virginia, in 1792 Kentucky became the 15th state to join the Union. Kentucky is the 37th most extensive and the 26th most populous of the 50 United States.
Ke...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$84,167 to $102,740
Most Popular Cities in Kentucky for Medical Policy Specialist Jobs
What does a Medical Policy Specialist do?
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