Medical Policy Specialist jobs in Cincinnati, OH

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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Anti-Human Trafficking Attorney 2-Year Fellow – Second Chance Project
  • Ohio Justice and Policy Center
  • Cincinnati, OH FULL_TIME
  • Position Description:

    As a result of their traffickers’ exploitation, survivors of human trafficking accumulate criminal records by being coerced into engaging in criminal activities against their will for their traffickers’ profits. Criminal convictions come with collateral sanctions attached, which are civil legal disabilities that exclude survivors from employment, housing, education, professional licensing, volunteering, and more, solely because they have certain criminal convictions. In response to this problem, the Ohio legislature established “safe harbor” expungement (R.C. 2953.36 and 2953.521) to erase criminal records resulting from human trafficking victimization.

    Montgomery County is home to over 500,000 people, including Ohio’s sixth most populated city of Dayton, and yet only one of Montgomery County’s six courts has ever handled safe harbor expungement applications. Therefore, human trafficking survivors do not have full access to resources to overcome the barriers of their records through safe harbor expungement.

    The Ohio Justice & Policy Center (OJPC) will host an attorney fellow over two years to support its Second Chance Project’s anti-human trafficking work. The attorney fellow will work with OJPC to accomplish the following objectives:

    1. Develop the safe harbor expungement processes and procedures for Montgomery County courts. Once trained and mobilized, the attorney fellow will assist with executing trainings and process development for purposes of establishing the court’s trauma-informed safe harbor expungement process.

    2. Expand the availability of knowledgeable and trained attorneys and social service providers to assist survivors of human trafficking with safe harbor expungement. Once trained and mobilized, the attorney fellow will execute trainings to teach pro bono attorneys and social service providers about safe harbor expungement to expand access to resources for survivors of human trafficking. 3. Provide direct legal assistance to survivors of human trafficking survivors with criminal records in Montgomery County. The attorney fellow will work with attorneys and partner organizations to plan and execute Second Chance Legal Clinics to screen for eligible survivors of human trafficking with criminal records and assist them with safe harbor expungement applications (or other post-conviction tools to help mitigate the impacts of their criminal records).

    4. Communicate with local stakeholders that are knowledgeable about the problem that this fellowship project seeks to address, and supportive of this project.

    5. Collect accurate data and assist OJPC will assessing the impact of this fellowship project on serving survivors of human trafficking.

    This fellowship position is an excellent opportunity to serve survivors of human trafficking in a meaningful way and invest in the development of resources to ensure that survivors have access to justice and relief.

    ESSENTIAL FUNCTIONS:

    1. Engage with prospective clients to collect client and case backgrounds/histories, identify legal and non-legal issues, and research available tools to best address needs.

    2. Provide full, direct legal representation for individuals that are unable to adequately represent themselves.

    3. Participate in Second Chance Legal Clinics to screen for survivors of human trafficking, which includes evaluating eligibility for post-conviction legal services and providing brief pro se legal advice or full representation to clinic participants.

    4. Become knowledgeable on the legal services provided by the Second Chance Project, and provide assistance with record sealing and expungement (R.C. 2953.32), safe harbor expungement (R.C. 2953.36), Certificate of Qualification for Employment (CQE) (R.C. 2953.25), and pardons (R.C. 2967.04).

    5. Build and maintain rapport with clients to secure engagement and consistent communication.

    6. Collaborate with the Second Chance Project team to conduct community presentations and trainings on OJPC’s services and the legal tools available to survivors of human trafficking with criminal records.

    7. Engage with legal, social service, and re-entry organizations in the community to understand what services are available for trafficking survivors with criminal records, and provide trusted referrals as needed.

    8. Cultivate and leverage relationships with professionals in the criminal legal system, such as attorneys, clerks, prosecutors, judges, law enforcement officers, policy makers, and/or politicians.

    ADMINISTRATIVE AND OTHER FUNCTIONS:

    1. Conduct client intake and information management, which includes organizing and maintaining digital and physical files. Input client information and data into OJPC’s case management software. Regularly update Second Chance Project caseload tracker and other data-tracking tools.

    2. Review, analyze, and organize documents.

    3. Find, review, and discuss client case histories using online portals and/or documents like police reports and BCI/FBI background checks.

    4. Maintain and prepare data for funding and operational reports.

    5. Input timely and consistent updates to client files in OJPC case management software. Track resolution(s) of issues and input updates.

    6. Refer prospective or current client(s) to proper OJPC staff or other organizations.

    7. Meet with supervisor to review work plans, activities, and projects.

    8. Meet annually with supervisor for a performance review.

    COMPETENCIES/SKILLS:

    1. Problem Solving

    2. Tenacity

    3. Thoroughness/Attention to Detail

    4. Teamwork Orientation

    5. High Level of Communication Skills and Interpersonal Skills

    6. Emotional Intelligence

    7. Personal Initiative

    8. Personal Effectiveness/Credibility

    9. Comfortable with using technology (e.g. Microsoft Suites, including Teams and Excel)

    MINIMUM QUALIFICATIONS:

    1. Admitted to the bar in the State of Ohio.

    2. Aptitude and compassion to work with survivors of human trafficking and people who have been impacted by the criminal legal system.

    3. Ability to serve for a 2-year term.

    ADDITIONAL QUALIFICATIONS:

    1. Excellent legal research and writing experience.

    2. An ability to provide victim-centered, trauma-informed, and culturally competent legal assistance to survivors.

    3. An ability to work collaboratively in a variety of contexts and with multiple organizations/entities to facilitate comprehensive services to human trafficking survivors.

    4. Ability to write reports, correspondences, and procedure manuals.

    5. Experience with public speaking and/or conducting presentations.

    6. Knowledge of additional Microsoft Office software, such as Excel and PowerPoint.

    WORK ENVIRONMENT:

    This job operates in a professional office with a hybrid work environment requiring staff to be on-site a minimum of three days a week. Normal working hours are 9:00 a.m. to 5:00 p.m. daily. This role routinely uses standard office equipment such as computers, phones, multi-functional printers, postage meters and scanners.

    TRAVEL:

    This fellowship project is focused on serving survivors of human trafficking in Montgomery County. Successful applicants will be required to travel to and within Montgomery County. Since OJPC’s Second Chance Project is based in Cincinnati, traveling and working in-office in Cincinnati may be required as needed.

    PHYSICAL DEMANDS:

    Prolonged periods of sitting at a desk and working on a computer. The position requires the employee to be able to lift up to 15 pounds at a time.

    AFFIRMATIVE ACTION PLAN:

    Employment decisions at OJPC will be based on merit, qualifications, and abilities. OJPC does not discriminate in employment opportunities or practices on the basis of race, color, religion, sex, national origin, age, disability, or any other characteristic protected by law. We will make reasonable accommodations for qualified individuals with known disabilities unless doing so would result in an undue hardship. This policy covers all aspects of employment, including selection, job assignment, compensation, discipline, termination, and access to benefits and training.

    APPLICATION PROCESS:

    Applications will be accepted until April 22, 2024. Interested candidates are encouraged to apply as soon as possible with the following materials:

    1. Cover Letter

    2. Resume

    3. Three (3) References

    Email application materials in PDF format to OJPC paralegal Takia Chappell at tchappell@ohiojpc.org. The email’s subject line should include: Anti-HT Attorney Fellow Application.

    Job Type: Full-time

    Pay: $60,000.00 per year

    Benefits:

    • 401(k)
    • 401(k) matching
    • Dental insurance
    • Health insurance
    • Life insurance
    • Paid time off
    • Vision insurance

    Schedule:

    • 8 hour shift
    • Monday to Friday

    People with a criminal record are encouraged to apply

    Ability to Relocate:

    • Cincinnati, OH 45202: Relocate before starting work (Required)

    Work Location: In person

  • 7 Days Ago

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Staff Attorney-Second Chance Project
  • Ohio Justice and Policy Center
  • Cincinnati, OH FULL_TIME
  • Position Description: The Ohio Justice & Policy Center (OJPC) is a Cincinnati-based nonprofit law firm whose mission is to create fair, intelligent, redemptive criminal justice systems through zealous...
  • 7 Days Ago

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Billing Specialist
  • QUIPT HOME MEDICAL INC
  • Wilder, KY FULL_TIME
  • DescriptionWe are rapidly growing leader in the provision of clinical respiratory equipment, DME and service that is seeking outstanding individuals to join our team of professionals. Due to our succe...
  • 16 Days Ago

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Medical Billing Specialist
  • Elite Physical Medicine and Rehabilitation
  • Lawrenceburg, IN FULL_TIME
  • Elite Physical Medicine is looking for an experienced Medical Biller. We are growing and need experienced, motivated, and enthusiastic individuals to join our team. Please note, this role is on locati...
  • 17 Days Ago

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Medical Laboratory Specialist
  • ArmyRecruiting Ohio
  • Mason, OH FULL_TIME
  • APPLY HERE: https://www.goarmy.com/info/send1/?iom=QB17 The Army Virtual Recruiting Team of Columbus Ohio is currently looking to hire Active Duty and Reserve Soldiers. You must enlist in the United S...
  • Just Posted

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Medical Billing Specialist
  • Northeast Cincinnati Pediatric Associates, Inc.
  • Cincinnati, OH FULL_TIME
  • This is a full time position at our Sycamore location. Hours are Monday through Friday, no weekends. Position Requirements: At least 2 years' experience in medical billing required as well as knowledg...
  • Just Posted

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0 Medical Policy Specialist jobs found in Cincinnati, OH area

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Immunologist- Medical Director
  • Medpace
  • Cincinnati, OH
  • Job SummaryWe are seeking an Immunologist- Medical Director to join our dynamic team. The Medical Director will have ove...
  • 4/24/2024 12:00:00 AM

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Hedging & Contract Specialist
  • Nucor Harris Rebar
  • Cincinnati, OH
  • Nucor is North America's largest recycler and most diversified steel and steel products company. Since 1969, we've led t...
  • 4/23/2024 12:00:00 AM

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Clinical Trial Manager- Biosciences
  • Procter & Gamble Company
  • Cincinnati, OH
  • Job Location Cincinnati Job Description Entry level for employees who develop proficiency in Biosciences. Procedural wor...
  • 4/23/2024 12:00:00 AM

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Join Our Team at Good Samaritan Hospital Med-Surg Registered Nurse Opportunities Available Now! Night shift - Base pay rate + hourly incentives + bonuses!
  • TriHealth
  • Cincinnati, OH
  • Job Description Our Magnet recognized Good Samaritan Hospital have currently nursing opportunities available in the foll...
  • 4/22/2024 12:00:00 AM

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Field Service Engineer (Cincinnati, Ohio ) Field Based Ohio
  • BD
  • Cincinnati, OH
  • Responsibilities Job Description Summary Summary: The Field Service Engineer is responsible for providing on-site suppor...
  • 4/22/2024 12:00:00 AM

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Forecasting Internship - Fall 2024
  • Medpace, Inc.
  • Cincinnati, OH
  • Job Summary: Our Strategy and Insights team is a crucial function within Commercial Operations at Medpace, which is a hi...
  • 4/21/2024 12:00:00 AM

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WDC Operations Manager
  • Cincinnati State
  • Cincinnati, OH
  • Job Description - WDC Operations Manager The Workforce Development Center (WDC) at Cincinnati State is the region's lead...
  • 4/21/2024 12:00:00 AM

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Psychiatrist - Medical Director
  • Medpace
  • Cincinnati, OH
  • Job Summary We are seeking a Psychiatrist - Medical Director to join our dynamic team. The Medical Director will have ov...
  • 4/20/2024 12:00:00 AM

Cincinnati (/ˌsɪnsɪˈnæti/ SIN-sih-NAT-ee) is a major city in the U.S. state of Ohio, and is the government seat of Hamilton County. Settled in 1788, the city is located at the northern side of the confluence of the Licking and Ohio rivers, the latter of which marks the state line with Kentucky. The city drives the Cincinnati–Middletown–Wilmington combined statistical area, which had a population of 2,172,191 in the 2010 census making it Ohio's largest metropolitan area. With a population of 296,943, Cincinnati is the third-largest city in Ohio and 65th in the United States. Its metropolitan ar...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$87,477 to $106,780
Cincinnati, Ohio area prices
were up 1.1% 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