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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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 enhance your skills in various areas such as reporting, pulling call lists, ensuring that dialer calls stay up to date, policy delivery troubleshooting, and assisting clients with any hurdles they encounter along the way.

    Why Zander?
    As we settle into 2021, most of us could use a fresh start. What better way to do that than with a rewarding new career? We know these past few months have been hard, which is why we’ve continued to offer all of our employees the best benefits package in the industry and celebrate our successes every chance we get. From Employee Appreciation Week to fun (and safe!) team-building activities, culture is a top priority here at Zander. Come see for yourself!

    What we have to offer:

    • Health and dental insurance paid 100% by Zander
    • Meaningful work protecting families
    • Work from the comfort of your home
    • Employee Stock Ownership Plan after one year
    • Base salary plus bonuses
    • All leads provided (no cold-calling or prospecting)
    • 5% dollar-for-dollar matching on your 401(k)
    • Generous paid time off
    • Growth and leadership opportunities – we promote from within

    And much more!

    Your role in protecting families will include:

    • Working with Excel reports to create and schedule call lists each day
    • Making upwards of 150 outbound calls per day via automatic dialing system
    • Assisting clients in completing requirements needed for activating coverage
    • Troubleshooting policy delivery and activation issues
    • Communicating with clients, insurance companies, and our team with the goal of ensuring clients’ success in accepting the policy and resolving any complaints
    • Auditing carrier websites for incomplete, active, and pending files
    • Providing top-notch customer service to each client: empathy, guidance, education, and expectation-setting
    • Aiding in CSR report follow-up which may include phone call and email correspondence to carrier and client

    Who you are:
    As unemployment continues to rise, we welcome candidates from all backgrounds, including the service, tourism, and hospitality industries. If you’re hard-working, positive, and have the heart of a teacher, we’ll help you grow as a professional so that you excel here at Zander.

    • You have a High School Diploma or equivalent.
    • You have a typing speed of at least 40 WPM
    • You are a critical thinker with excellent analytical skills
    • You have inbound/outbound call center and customer service experience in roles requiring the use of persuasion
    • You are experienced with Microsoft Office (particularly Excel)
    • You have 1 year of experience in the insurance industry
    • You have 3 years of customer service experience in an office setting
    • You have demonstrated experience working in a fast-paced, team-oriented and deadline-oriented environment
    • You are reliable, adaptable, and compassionate
    • You have the ability to work from home
    • Bonus points if you have sales experience in insurance or financial services

    ESSENTIAL FUNCTIONS:

    These essential functions are representative of those that must be met by an employee to successfully perform the physical aspects of the job. Reasonable accommodation may be made to enable individuals with disabilities to perform these essential functions.

    • · Use of office equipment including personal computer, multiple screens, printer, fax machine, scanner and telephone;
    • · The employee is occasionally required to use hands and fingers to operate, handle, and reach;
    • · Specific vision abilities required by this job include close vision and the ability to adjust focus;
    • · Communicate effectively in English, writing and verbally in person, via email, video meetings and telephone;
    • · Communicate effectively via telephone for extended periods of time, up to 7 hours per day;
    • · Ability to pay attention, listen actively, analyze problems and evaluate options, focused on task, multi-task, decision making, and engage appropriately;
    • · Ability to appropriately handle stress in a fast-paced environment and interact appropriately with others;
    • · Sit & stand for extended periods of time up to 7 hours per day;
    • · Must be able to walk up and down stairs (there are no elevators in the 2-story main office building);
    • · Physical, consistent attendance during normal working hours within a standard 40-hour workweek, during the shift required for this position, as many of the job duties are time sensitive and most effectively and efficiently resolved only through required immediate communication; additional hours may be required;
    • · The noise level in the work environment is usually moderate to loud.
  • 15 Days Ago

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Health Policy Data Analyst - Modeling - Remote Hybrid
  • Vanderbilt University Medical Center
  • Nashville, TN FULL_TIME
  • Discover Vanderbilt University Medical Center: Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of diverse individual...
  • Just Posted

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Attorney - In-House/Litigation (Remote)
  • Firearms Policy Coalition
  • Nashville, TN OTHER
  • This is not a mere job post for another corporate role. This is an opportunity to join an impactful team of freedom fighters and change the course of history. This is a mission, a calling. This is abo...
  • 1 Month Ago

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Attorney - In-House/Litigation (Nashville-area)
  • Firearms Policy Coalition
  • Hendersonville, TN FULL_TIME
  • This is not a mere job post for another corporate role. This is an opportunity to join an impactful team of freedom fighters and change the course of history. This is a mission, a calling. This is abo...
  • 1 Month Ago

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Medical Device Sales - Product Specialist
  • Tactile Medical
  • Knoxville, TN FULL_TIME
  • Overview The Product Specialist is responsible for educating therapists, physicians and patients on Tactile Medical Products in an assigned territory. Responsible for establishing sales strategies to ...
  • 22 Days Ago

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Medical Billing Specialist
  • FlexWorx Medical Management
  • Memphis, TN FULL_TIME
  • FlexWorx has been in business and taking care of patients for 23 years. Our integrated healthcare services include primary care, orthopedic, neurosurgeon, neurologist, and physical therapy. We are ope...
  • 21 Days Ago

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Ambulatory Medication Specialist
  • Children's National Medical Center
  • Washington, DC
  • Under the direct supervision of a registered pharmacist and under the leadership the Pharmacy Management staff, the Ambu...
  • 3/28/2024 12:00:00 AM

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Medical Specialist 2
  • New York State Civil Service
  • Thiells, NY
  • Agency People With Developmental Disabilities, Office for Title Medical Specialist 2 Occupational Category Health Care, ...
  • 3/28/2024 12:00:00 AM

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Medical Specialist - Pulmonology - Gary, IN
  • Regeneron Pharmaceuticals
  • Indianapolis, IN
  • The Medical Specialist (Sales Representative), Pulmonology (MS) will be responsible for engaging Pulmonologists and othe...
  • 3/28/2024 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...
  • 3/27/2024 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...
  • 3/27/2024 12:00:00 AM

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Medication Specialist
  • Behavorial Health Network, Inc
  • Boston, MA
  • Use your knowledge of addiction recovery and medication management with BHN! Join our team of competent and compassionat...
  • 3/26/2024 12:00:00 AM

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Medical Assistant, Medical Specialists
  • UP Health System - Marquette
  • Marquette, MI
  • UP Health System - Marquette Medical Assistant, Medical Specialists, 1.0DV Who We Are: People are our passion and purpos...
  • 3/26/2024 12:00:00 AM

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Medical Specialist 2
  • StateJobsNY
  • Queens Village, NY
  • MMINIMUM QUALIFICATIONS: Possession of a license to practice medicine in New York State (see limited permit option below...
  • 3/25/2024 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
$82,051 to $100,156

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