Medical Policy Specialist jobs in Appleton, WI

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 Assembler
  • Acuity Insurance
  • Sheboygan, WI FULL_TIME
  • Acuity is seeking a Policy Assembler for the mailing of personal lines and commercial lines new business, renewals, and policy changes to agents and insureds. This position assists Billing with opening cash and Mail Room with closing agency mail on a daily basis, while also creating commercial lines certified copies of policies for claims in review or dispute.

    ESSENTIAL FUNCTIONS:

    • Prepare daily print: sort and adjust stacks, print audits/mants, prep documents for imaging, locate and pull print, troubleshoot missing print, distribute print to helps. 
    • Assemble personal lines and commercial lines new business, renewals, and policy changes for mailing. 
    • Prepare policies, bills, and other notices requiring proof of mailing. Verify all pieces are accounted for, all postal forms are accurately completed, and all charges have been properly applied based on the type of proof of mailing. 
    • Type appropriate forms. 
    • Open and enter payments. 
    • Rack and close agency mail in the Mail Room. 
    • Create commercial lines certified copies of policies. 
    • Regular and predictable attendance.
    • Performs other duties as assigned.

    EDUCATION:

    High school diploma.

    EXPERIENCE:

    None required. Multiple years of relevant experience preferred.

    OTHER QUALIFICATIONS:

    • Ability to lift 30 pounds.
    • Ability to push 135-pound cart around the building, up ramps, around corners, and through doorways, approximately 1,300 feet.
    • Ability to follow instructions and exhibit strong attention to detail.
    • Ability to produce neat and accurate work.
    • Strong problem-solving skills.
    • Ability to organize and work independently as well as in a team environment with minimum supervision.
    • Ability to adjust to peak workloads and priorities. Willingness to constructively and professional voice ideas and opinions in daily meetings.
    • Proficient with Microsoft Outlook, Word, and Internet applications. Ability to achieve 6,000-6,500 keystrokes per hour on alphanumeric data entry with minimal errors.
    • Requires 100% onsite hours to support the needs of the team.

    This job is classified as non-exempt. 

    We are an Equal Employment Opportunity employer. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

      1. 1 Day Ago

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      Policy Assembler
      • ACUITY, A Mutual Insurance Company
      • Sheboygan, WI FULL_TIME
      • Acuity is seeking a Policy Assembler for the mailing of personal lines and commercial lines new business, renewals, and policy changes to agents and insureds. This position assists Billing with openin...
      • 1 Day Ago

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      Rehab Specialist- Medical Equipment
      • SSM Health
      • Fond du Lac, WI PART_TIME
      • It's more than a career, it's a calling.WI-Agnesian Health ShoppeWorker Type:RegularJob Highlights:At SSM Health, we know the healing power of presence begins with compassionate employees like you. Ou...
      • 23 Days Ago

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      Medical Billing and Insurance Specialist
      • Family Foot and Ankle Clinic
      • Schofield, WI FULL_TIME
      • Job description Family Foot and Ankle Clinic is a private practice Podiatry Clinic serving 7 locations in Wisconsin, and we are seeking a detail oriented and experienced Medical Billing and Insurance ...
      • 11 Days Ago

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      Medical Billing Specialist
      • Sheboygan Physicians Group - Sheboygan Internal Medicine
      • Sheboygan, WI FULL_TIME
      • Busy internal medicine practice seeking a Billing and Credit Services Associate for a full-time position at our Sheboygan location. Accounts receivable experience and attention to detail are essential...
      • 13 Days Ago

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      Specialist, Medical Office
      • TruGreen
      • River, WI FULL_TIME
      • Immediate Openings in Appleton, WI At TruGreen, we are committed to our customers, our teams, our values, and the science of lawn care. Average income is $850 - $1,200 per week* - Based on hourly rate...
      • 28 Days Ago

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      0 Medical Policy Specialist jobs found in Appleton, WI area

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      Cath Lab Technician - Traveler
      • Ascension
      • Appleton, WI
      • Details Weekly Rates: $2612 - $3651 Department: Associate Travel Program - Cardiac Cath Lab Or IR Schedule: Multiple Shi...
      • 4/25/2024 12:00:00 AM

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      Assistant Electrical Project Manager
      • Faith Technologies Incorporated (FTI)
      • Menasha, WI
      • Faith Technologies, a division of Faith Technologies Incorporated (FTI), is an energy expert and national leader in elec...
      • 4/25/2024 12:00:00 AM

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      CDL-A OTR Team Drivers - Top Team Pay + Great Benefits
      • U.S. Xpress
      • Appleton, WI
      • U.S. Xpress is Now Hiring CDL-A OTR Team Drivers! CDL-A Teams: Top Team Pay in the Nation & Up To $15,000 Sign-On Bonus/...
      • 4/24/2024 12:00:00 AM

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      CDL-A OTR Team Drivers - Average Up to $200k/Year + Benefits
      • U.S. Xpress
      • Appleton, WI
      • U.S. Xpress is Now Hiring CDL-A OTR Team Drivers! Your team can average $200,000 or more! Dont have a team partner? We w...
      • 4/24/2024 12:00:00 AM

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      Packaging R&D Engineer
      • Blue Signal Search
      • Menasha, WI
      • Packaging R&D Engineer Our client is a global leader in the sustainable packaging industry, with a commitment to innovat...
      • 4/24/2024 12:00:00 AM

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      CDL-A OTR Team Drivers - Top Team Pay + Great Benefits
      • U.S. Xpress
      • Menasha, WI
      • U.S. Xpress is Now Hiring CDL-A OTR Team Drivers! CDL-A Teams: Top Team Pay in the Nation & Up To $15,000 Sign-On Bonus/...
      • 4/24/2024 12:00:00 AM

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      Phlebotomist
      • GRIFOLS, S.A.
      • Menasha, WI
      • For more than 75 years, Grifols has worked to improve the health and well-being of people around the world. We are a glo...
      • 4/22/2024 12:00:00 AM

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      CDL-A Team Drivers - Earn Up to $100k/Year + Up to $15k Split Sign-On
      • U.S. Xpress
      • Appleton, WI
      • U.S. Xpress is now hiring CDL-A OTR Team Drivers CDL-A Teams: Top Team Pay in the Nation & Up To $15,000 Sign-On Bonus/S...
      • 4/21/2024 12:00:00 AM

      Appleton is a city in Outagamie (mostly), Calumet, and Winnebago counties in the U.S. state of Wisconsin. One of the Fox Cities, it is situated on the Fox River, 30 miles (48 km) southwest of Green Bay and 100 miles (160 km) north of Milwaukee. Appleton is the county seat of Outagamie County. The population was 72,623 at the 2010 census. Of this, 60,045 were in Outagamie County, 11,088 in Calumet County, and 1,490 in Winnebago County. Appleton is the principal city of the Appleton, Wisconsin Metropolitan Statistical Area, which is included in the Appleton-Oshkosh-Neenah, Wisconsin Combined Sta...
      Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
      Income Estimation for Medical Policy Specialist jobs
      $86,672 to $105,797
      Appleton, Wisconsin area prices
      were up 1.3% from a year ago

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