Medical Policy Specialist jobs in West Virginia

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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Family Assistance Policy and Systems Training Specialist
  • WV Department of Human Services
  • UNKNOWN, WV FULL_TIME
  • *Please note, by clicking APPLY, a WV Department of Human Services Talent Acquisition Team Member may reach out to you regarding further pertinent application steps.

    Nature of Work: Under general supervision, this position will provide Family Assistance Policy and Systems Training to new and tenured staff. Interprets federal and state laws, regulations, and policies for staff to ensure that training property represents policy in the curriculum. Writes, edits, and develops curricula consistent with a competency-based training system to ensure basic proficiency and continued professional development of Family Assistance and clerical staff. Uses independent judgment in administrative and operational aspects of training provision including use of facilities, classroom management, equipment management, and trainee supervision. Acts as a liaison with regional and district offices to ensure that training needs are met. Other duties as assigned. This position requires statewide travel.

    2 Vacancy
    Statewide

    Minimum Qualifications

    Training: Bachelor's Degree from a regionally accredited four-year college or university. Substitution: Additional experience as described below may be substituted for the required training on a year-for-year basis.

    Experience: Four years full-time, equivalent part-time paid or volunteer experience in a technical or program area that is related to the area of employment. Substitution: Post-graduate education in a field related to the technical or program area may be substituted for the required experience on the basis of fifteen semester hours for one year of experience.

    Job Type: Full-time

    Pay: $35,994.00 - $66,589.00 per year

    Benefits:

    • Dental insurance
    • Flexible spending account
    • Health insurance
    • Life insurance
    • Paid time off
    • Retirement plan
    • Tuition reimbursement
    • Vision insurance

    Schedule:

    • 8 hour shift
    • Monday to Friday

    Application Question(s):

    • Do you have four years full-time, equivalent part-time paid or volunteer experience in a technical or program area that is related to the area of employment?

    Education:

    • Bachelor's (Required)

    Work Location: In person

  • 27 Days Ago

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Academic Officer
  • WV Higher Education Policy Commission
  • Kanawha, WV FULL_TIME
  • JOB This position is responsible for ensuring compliance with academic policies and processes in the Academic Affairs division of the West Virginia Higher Education Policy Commission (Commission) and ...
  • 15 Days Ago

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Academic Officer
  • West Virginia Higher Education Policy Commission
  • Charleston, WV FULL_TIME
  • General Job Summary This position is responsible for ensuring compliance with academic policies and processes in the Academic Affairs division of the West Virginia Higher Education Policy Commission (...
  • 15 Days Ago

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Vice Chancellor for Finance and Facilities
  • West Virginia Higher Education Policy Commission
  • Charleston, WV FULL_TIME
  • General Job Summary Under administrative direction from the Chancellor for Higher Education and/or the Executive Vice Chancellor for Administration, performs significant complex professional and admin...
  • 26 Days Ago

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Insurance Specialist
  • Berkeley Medical Center
  • Martinsburg, WV FULL_TIME
  • Welcome! We're excited you're considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. B...
  • 15 Days Ago

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HIM Specialist
  • Watertown Regional Medical Center
  • Beckley, WV FULL_TIME
  • Raleigh General HospitalDescription Raleigh General Hospital Who We Are: People are our passion and purpose. Come work where you are appreciated for who you are not just what you can do. Raleigh Gener...
  • 17 Days Ago

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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...
  • 4/23/2024 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...
  • 4/22/2024 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...
  • 4/22/2024 12:00:00 AM

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RN-WMG-Endo Medical Specialist-Days
  • Wellstar Medical Specialists
  • Marietta, GA
  • Summary: Ambulatory/Outpatient refers to medical services performed on an outpatient basis, without admission to a hospi...
  • 4/22/2024 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...
  • 4/21/2024 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...
  • 4/21/2024 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...
  • 4/20/2024 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

West Virginia (/vərˈdʒɪniə/ (listen)) is a state located in the Appalachian region in the Southern United States and is also considered to be a part of the Middle Atlantic States. It is bordered by Pennsylvania to the north, Maryland to the east and northeast, Virginia to the southeast, Kentucky to the southwest, and Ohio to the northwest. West Virginia is the 41st largest state by area, and is ranked 38th in population. The capital and largest city is Charleston. West Virginia became a state following the Wheeling Conventions of 1861, after the American Civil War had begun. Delegates from so...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$80,500 to $98,264

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