Medical Policy Specialist jobs in Champaign, IL

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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Medical Staff Office Specialist FT40
  • KIRBY MEDICAL CENTER
  • Center, IL OTHER
  • Description: Under the direction of the MSO Director and Medical Staff Coordinator the Medical Staff Specialist is  accountable for the credentialing and re-credentialing of all physicians and allied health practitioners.  Also assist in maintaining numerous physician information data banks, including education, training, experience, certification, and licensure.  Understands and follows the organization's policies, procedures, and standards.  Is an independent worker, meeting the day-to-day needs.  Participates in the department's performance improvement activities. This is a hybrid position post training period and will include the ability to work flexible hours and possess the ability to accept change.

    Qualifications:

    • Minimum of 3 years medical office related experience.
    • Certification by the National Association of Medical Staff Services preferred.
    • 3 years of working in a medical staff office performing credentialing duties preferred.
    • CPCS certification by the National Association of Medical Staff Services or willing to obtain certification within 5 years preferred.
    • Strong organizational and interpersonal skills.
    • Outstanding written and verbal communication skills.
    • Detail-oriented with the ability to multi-task and follow through to meet deadlines and stringent guidelines.
    • Must be self-motivated and strive for personal growth.
    • Familiar with medical terminology.
    • Proficient with Microsoft Office products – Word, Excel, Outlook, Power Point, Teams, and multiple databases.  CAQH and MD Staff credentialing software is a positive.   

    Benefits:

    • 40 hours of PTO effective date of hire.
    • Generous 401(k) match effective after 90 days.
    • Health, Dental, Vision and Life insurance effective date of hire.
    • Quality/Goal incentive annually.
    • Free Wellness Program.

    Since 1941, Kirby Medical Center has been the premier provider of healthcare in Piatt County and surrounding areas. We are committed and proud to provide quality and compassionate healthcare services to people in need. Our values-based culture, employee engagement, and award winning healthcare have driven the success of our organization. Kirby Medical Center is an independent, not-for-profit hospital located on a beautiful campus in Monticello, IL with satellite clinics in Atwood, & Cerro Gordo, IL.  Kirby Medical Center offers an outstanding benefits package and state-of-the-art medical equipment. Ideal candidates enjoy a workplace where compassion, positive attitudes, respect, excellence, and stewardship are on display every day.

  • 2 Months Ago

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Director, Policy Design & Administration
  • Universtiy of Illinois Urbana-Champaign
  • Champaign, IL FULL_TIME
  • Director, Policy Design & Administration Illinois Human Resources - Strategic Programs & Partnerships Job Summary Leads the development and maintenance of campus level human resources polices for Illi...
  • 22 Days Ago

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Product Owner, Underwriting & Policy Systems (Remote)
  • CCMSI
  • Danville, IL OTHER
  • Overview At CCMSI, we look for the best and brightest talent to join our team of professionals. As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of ...
  • 18 Days Ago

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Business Policy and Procurement Coordinator – Carl R. Woese Institute for Genomic Biology
  • illinois
  • Urbana, IL FULL_TIME
  • Duties & ResponsibilitiesContract Management & Purchasing •Develops, reviews, interprets, and makes suggestions for contractual documents, maintenance agreements, consulting contracts, and travel and ...
  • 22 Days Ago

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Travel Registered Nurse RN Medical Surgical Telemetry
  • OneStaff Medical
  • URBANA, IL FULL_TIME
  • We. Are. OneStaff. Medical. An independently - owned, nationally - recognized and amazingly awesome staffing firm ready to work for you! A work ethic forged in the Midwest, we are here to stand by you...
  • 14 Days Ago

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Travel Registered Nurse RN Medical Surgical
  • OneStaff Medical
  • CLINTON, IL FULL_TIME
  • We. Are. OneStaff. Medical. An independently - owned, nationally - recognized and amazingly awesome staffing firm ready to work for you! A work ethic forged in the Midwest, we are here to stand by you...
  • 1 Month Ago

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0 Medical Policy Specialist jobs found in Champaign, IL area

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Engagement Specialist Overnight - Mobile Crisis Response
  • Rosecrance
  • Champaign, IL
  • Let's change lives together. Join a purpose-driven community of champions. Position Purpose: Provide support to mobile c...
  • 4/26/2024 12:00:00 AM

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RN - Pre-op (Procedural)
  • Hiring Now!
  • Champaign, IL
  • The staff Registered Nurse (RN) is a professional caregiver who assumes responsibility for a group of patients for a des...
  • 4/25/2024 12:00:00 AM

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Radiologic Technologist - Rad Tech
  • Hiring Now!
  • Champaign, IL
  • To perform routine and specialized diagnostic radiological procedures for patients of all ages in order to confirm or de...
  • 4/24/2024 12:00:00 AM

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AE - Merchandising Team Leader (Assistant Manager) - US
  • AMERICAN EAGLE OUTFITTERS INC.
  • Champaign, IL
  • BE PART OF SOMETHING REAL YOUR ROLE As the full-time Merchandising Team Leader, you are the Store Team Leader's "go-to" ...
  • 4/24/2024 12:00:00 AM

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Nurse Practitioner
  • Milan Laser Hair Removal
  • Champaign, IL
  • About Milan Laser Hair Removal Milan Laser Hair Removal is one of the nation's premier laser hair removal providers. Tha...
  • 4/24/2024 12:00:00 AM

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Counselor (LCSW/LCPC) - Psychiatry
  • Carle Foundation Hospital
  • Champaign, IL
  • * Provide mental health counseling/therapy to patients and their families through individual and/or group settings. * Pe...
  • 4/24/2024 12:00:00 AM

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Nurse Practitioner
  • Milan Laser Company
  • Champaign, IL
  • About Milan Laser Hair Removal Milan Laser Hair Removal is one of the nation's premier laser hair removal providers. Tha...
  • 4/23/2024 12:00:00 AM

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Property Operations Specialist
  • Fairlawn Management Inc
  • Champaign, IL
  • Job Type Full-time Description We are seeking a highly motivated Property Operations Specialist to join our awesome team...
  • 4/22/2024 12:00:00 AM

Champaign (English: /ˌʃæmˈpeɪn/) is a city in Champaign County, Illinois, United States. The city is 135 miles (217 km) south of Chicago, 124 miles (200 km) west of Indianapolis, Indiana, and 178 mi (286 km) northeast of St. Louis, Missouri. The United States Census Bureau estimates the city was home to 87,432 people as of July 1, 2017. Champaign is the tenth-most populous city in Illinois, and the state's fourth-most populous city outside the Chicago metropolitan area. It is included in the Champaign–Urbana metropolitan area. Champaign is notable for sharing the campus of the University of Il...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$86,582 to $105,688
Champaign, Illinois area prices
were up 1.3% from a year ago

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