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)
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:
And much more!
Your role in protecting families will include:
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.
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.