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)
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:
EDUCATION:
High school diploma.
EXPERIENCE:
None required. Multiple years of relevant experience preferred.
OTHER QUALIFICATIONS:
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.
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0 Medical Policy Specialist jobs found in Appleton, WI area