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)
Kidney Specialists of Minnesota (KSM) has been providing high-quality care to patients with CKD, diabetic kidney disease, and ESRD since 1978. We are looking to hire Full-Time Medical Assistants to help support our providers in clinic. KSM is an independent nephrology practice with 23 physicians and 7 advanced practice providers that deliver quality, patient-centered care in hospitals, dialysis units, and CKD clinic. KSM offers competitive benefits, and promotes work/life balance with no nights or weekends.
JOB PURPOSE
PATIENT CARE:
MANAGE PATIENT MEDICAL RECORDS
CLINIC OPERATIONS:
GENERAL RESPONSIBILITIES:
SKILLS/QUALIFICATIONS: