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 SUMMARY
The Health Information Management Specialist – Release of Information is responsible for maintaining medical record integrity through retrieving confidential patient records from the clinical floors. The specialist will also be responsible for collecting discharged records from the units, scanning observation records, analyzing ED records, answering the main HIM telephone line, organizing medical record requests and coordinates the completion with our ROI contractor CIOX. Completes records requests for patients who present to the hospital in a timely manner. This position may also be responsible for various tasks as assigned by the Director.
MINIMUM QUALIFICATIONS/REQUIREMENTS:
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0 Medical Policy Specialist jobs found in Galveston, TX area