Medical Policy Specialist jobs in Chico, CA

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 Coordinator
  • Paskenta Band of Nomlaki Indians
  • Corning, CA FULL_TIME
  • Native Preference in hiring is given to qualified enrolled members of Paskenta Band of Nomlaki Indians and Native Americans in accordance with the Band’s Preference Policy, Chapter 1-715 of the Paskenta Band of Nomlaki Indians Tribal Policies). Applicants claiming Indian Preference must submit verification of Indian certified by tribe of affiliation or other acceptable documentation of Indian heritage.

     

    POSITION SUMMARY

    Perform a wide variety of complex administrative duties under the direct supervision of the Policy Administrative Manager. The ideal candidate uses discretion and independent judgment to organize work effectively to meet critical administrative deadlines; completes projects and special assignments by establishing objectives, determining priorities, managing time, monitoring progress, problem solving and adjusting plans and priorities as needed. Must be comfortable managing multiple priorities, assigning priorities, setting up and documenting processes, finding efficiencies, and managing communications to implement processes and very effective time management and communication skills for the organization.

    DUTIES & RESPONSIBILITIES

    • Maintain confidentiality of government and operational information.
    • Provide excellent customer service to internal and external stakeholders.
    • Work closely with the Policy Manager in the development, documenting, and formatting of a variety of policy and governmental documents.
    • Develop and oversee general office administrative procedures, standardizing and communicating changes.
    • Create, edit and proof correspondence and reports independently.
    • Provide administrative support and coordination including but not limited to organizing and setting up meeting spaces for Tribal Council and Executive Staff.
    • Provide administrative support, maintain records of meetings and terms for committees.
    • Provide backup to Administrative Assistants and Tribal Office Receptionist.
    • Assist with basic accounting functions as needed including but not limited to coding invoices, logging A/R checks and completed purchase orders.
    • Assist with special projects or other administrative duties as needed.

    KNOWLEDGE, SKILLS & ABILITIES

    • High level of organizational skills, and ability to communicate effectively.
    • Demonstrated high level of time management skills and efficiency in office procedures.
    • High level of ability to act independently but maintain effective level of communication.
    • Demonstrated computer literacy, including proficiency in Microsoft Office software skills.
    • Excellent command of English language, spelling, grammar, and punctuation.
    • Very strong interpersonal and effective communication skills, both written and verbal.
    • Principles and practices of record keeping ability to maintain accurate and up to date files.
    • Ability to exercise discretion, maintain strict confidentiality and adhere to the Tribal Code of Ethics at all times.
    • Independently perform difficult administrative and support work involving the use of independent judgment and personal initiative.
    • Ability to type 50 wpm.
    • Ability to lift up to 25 lbs. safely.

    MINIMUM QUALIFICATIONS

    • Bachelor’s degree from an accredited college or university or a minimum of three (3) years working as a legal assistant.
    • Demonstrated experience in supporting management.
    • Experience in developing, editing, and implementing policy and procedures preferred.
    • Local travel is occasionally required. Travel outside of the state is infrequently required.  Typical travel time is generally less than a week.
    • Possess a valid California Driver’s License and be insurable by the Tribe.

    BACKGROUND CHECK REQUIREMENTS

    Pre-employment Drug Testing and a Department of Justice Fingerprinting clearance through Federal, State and Child Abuse Index is a contingency for an offer of employment.

    WORK ENVIRONMENT

    The position requires prolonged sitting, standing, walking, reaching, twisting, turning, kneeling, bending, squatting, and stooping in the performance of daily activities. The position also requires grasping, repetitive hand movement and fine coordination in preparing reports using a computer keyboard. Additionally, the position requires near and far vision in proofreading correspondence and work-related documents. Acute hearing is required. Typically, office work setting conditions.

     

    Employment with Paskenta Band of Nomlaki Indians is voluntarily entered. All PBNI personnel are employed on an at-will basis.  At-will employment may be terminated with or without cause, and with or without notice at any time by the employee or by PBNI. No manager, supervisor, or employee of the organization has any authority to enter into an agreement for employment for any specified period or to make an agreement for employment other than at-will terms. The job description does not constitute an employment agreement between Paskenta Band of Nomlaki Indians and employee and is subject to change by the Paskenta Band of Nomlaki Indians.

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Payroll Specialist
  • Red Oaks Medical Group Inc
  • Red Bluff, CA FULL_TIME
  • Job Summary: The mission of the Payroll Specialist is to effectively administer Payroll and Payroll Costing Reports in such a way as to be cost efficient and instill employee confidence in the process...
  • 21 Days Ago

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Billing Specialist
  • Red Oaks Medical Group Inc
  • Red Bluff, CA FULL_TIME
  • Job Title: Billing Specialist Department: Business Office Reports to: Business Office Supervisor/Revenue Cycle Manager Organizational Peers: Business Office Staff Supervisory Responsibilities: None Po...
  • 1 Month Ago

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Medical Data and Referrals Specialist
  • Redding Rancheria
  • Redding, CA FULL_TIME
  • ***This position is open through Friday, February 16, 2024***The Redding Rancheria is seeking a Medical Data and Referrals Specialist.The Preferred Schedule for this position is Monday- Friday from 8 ...
  • 16 Days Ago

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Perinatal Safety Specialist
  • Mercy Medical Center Redding
  • REDDING, CA FULL_TIME
  • OverviewFor more than 70 years Mercy Medical Center Redding has offered comprehensive health care in the North State providing acute care and a full range of medical services. The 267-bed hospital off...
  • 24 Days Ago

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Facilities Maintenance Specialist
  • Red Oaks Medical Group Inc
  • Red Bluff, CA FULL_TIME
  • Reports to: Facilities Manager and Facilities Engineer in the Manager’s absence Organizational Peers: Medical Assistants Patient Service Representatives Direct Reports: N/A Job Details: Full time, 40 ...
  • Just Posted

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0 Medical Policy Specialist jobs found in Chico, CA area

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Travel Registered Nurse RN Emergency Room ER
  • OneStaffMedical
  • CHICO, CA
  • We. Are. OneStaff. Medical. An independently - owned, nationally - recognized and amazingly awesome staffing firm ready ...
  • 4/24/2024 12:00:00 AM

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Commercial Sales Manager
  • AutoZone, Inc.
  • Chico, CA
  • The Commercial Sales Manager is responsible for driving the commercial sales within their AutoZone location. The CSM dev...
  • 4/24/2024 12:00:00 AM

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Veterinary Assistant - Pharmacy Dept.
  • VCA Animal Hospitals
  • Chico, CA
  • We are seeking an experienced Veterinary Assistant to join our team. The successful candidate will be a believer in the ...
  • 4/24/2024 12:00:00 AM

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Travel Nurse RN - ICU - Intensive Care Unit - $2,449 per week
  • TRS Healthcare
  • Chico, CA
  • OneStaff Medical is seeking a travel nurse RN ICU - Intensive Care Unit for a travel nursing job in Chico, California. J...
  • 4/24/2024 12:00:00 AM

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Oncology Data Specialist
  • Enloe Medical Center
  • Chico, CA
  • Pay Range: $ 31.19/hr - $ 35.28/hr - $ 39.93/hr *Please note, the highest starting rate as a new hire is $35.28/hr, base...
  • 4/22/2024 12:00:00 AM

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Inventory Specialist
  • LULUS FASHION LOUNGE LLC
  • Chico, CA
  • Job Details Job Location Hegan Warehouse - Chico, CA Position Type Full Time Education Level High School Salary Range $1...
  • 4/22/2024 12:00:00 AM

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Administrative Front Office Receptionist
  • Adecco Staffing, USA
  • Durham, CA
  • Adecco is assisting a local client in recruiting for a Receptionist job in Chico, CA. This is for a long term temp to hi...
  • 4/22/2024 12:00:00 AM

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General Dentist
  • Western Dental & Orthodontics
  • Chico, CA
  • Overview: Our General Dentists perform a variety of preventative, restorative, endodontic, and surgical procedures that ...
  • 3/30/2024 12:00:00 AM

Chico is the most populous city in Butte County, California, United States. As of the 2010 United States Census, the population was 86,187, reflecting an increase of 26,233 from the 59,954 counted in the 2000 Census. The city is the cultural, economic, and educational center of the northern Sacramento Valley and home to both California State University, Chico and Bidwell Park, the country's 26th largest municipal park and the 13th largest municipally-owned park. Bidwell Park makes up over 17% of the city. Other cities in close proximity to the Chico Metropolitan Area (population 212,000) incl...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$92,217 to $112,567
Chico, California area prices
were up 2.5% 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