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)
JOB DUTIES
Installs new / rebuilds existing servers and configures hardware, peripherals, services, settings, directories, storage, etc. in accordance with standards and project/operational requirements.
Implement systems for various project and operational needs.
Maintains knowledge of IT infrastructure.
Provides Supervisor, IS Technology regular project updates.
With a smile and in a positive fashion, communicates with other staff on key issues as required ensuring projects and tasks are being completed and documented as needed.
Completes work within acceptable time limits and demonstrates the ability to set priorities.
Demonstrates good judgment in handling situations not covered by written or verbal instructions.
Follows through with assignments and lets affected parties know if unable to complete task.
MINIMUM EDUCATION, KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED
IT Certifications or relevant degree required. Must be able to read, write and follow written and verbal directions.
Three (3) years’ experience in a Windows Server environment preferred. Additional relevant experience may be considered in lieu of the educational requirements.
A detailed knowledge of Windows environment is required.
Working knowledge of popular software products such as Microsoft Office is required.
Knowledge of Server virtualization is essential.
Requires working understanding of networking technology in a TCP/IP based network.
Analytical skills are mandatory to help ensure an organized approach to problem solving and system deployment.
Will provide direct infrastructure support for server based systems to help ensure users’ needs are met. Knowledge of MS Exchange, SQL Server, VMWare and Active Directory are considered vital skills.
Must be able to communicate and effectively exchange information with Information Systems staff, other Meadville Medical Center staff, physicians, physician office staff, and other customers
A strong working knowledge of the Windows Server Operating System platform is required.
Working knowledge of popular software products such as Microsoft Office is necessary.
Knowledge of Server virtualization is essential. Specifically, the VMware virtualization Technlogies.
Requires a basic understanding of networking technologies used in a TCP/IP based network.
Analytical skills are mandatory to help ensure an organized approach to problem solving and system deployment.
Will provide direct infrastructure support for server-based systems to help ensure users’ needs are met.
A strong working knowledge of MS Exchange, SQL Server, VMWare and Active Directory are considered vital skills.
Must be able to communicate and effectively. Written and verbal exchange of information with Information Systems staff, other Meadville Medical Center staff, physicians, physician office staff, and other customers is required.
Primarily in an office setting. May be required to be in various hospital departments. May need to work under stressful situations with frequent interruptions.
0 Medical Policy Specialist jobs found in Erie, PA area