Medical Policy Specialist jobs in Helena, MT

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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Paralegal - Contract & Policy Specialist
  • The Staff Pad
  • Helena, MT FULL_TIME
  • The Staff Pad is seeking a Paralegal - Contract and Policy Specialist. We are honored to partnered with a non-profit healthcare system in Helena, Montana with superior care and a hometown commitment to be the gold standard for health care in Montana.

    The Paralegal will provide legal support to the legal department of a hospital in Helena, Montana. This individual will assist in various legal matters related to healthcare operations, regulatory compliance, risk management, and litigation. The paralegal will work closely with attorneys, healthcare professionals, and administrative staff to ensure legal compliance and mitigate legal risks.

    Responsibilities:
    • Legal Research:Conduct legal research on healthcare regulations, statutes, and case law relevant to hospital operations.
    • Document Preparation:Draft and review legal documents, including contracts, agreements, policies, and correspondence.
    • Litigation Support: Assist in preparing legal documents for litigation, including discovery requests, pleadings, and motions.
    • Regulatory Compliance: Monitor changes in healthcare laws and regulations and assist in ensuring hospital compliance.
    • Risk Management: Assist in identifying and assessing legal risks to the hospital and developing strategies to mitigate those risks.
    • Records Management: Maintain organized and updated legal files and documentation, including electronic and physical records.
    • Administrative Support: Provide administrative support to the legal department, including scheduling meetings, managing calendars, and coordinating communications.
    • Collaboration:Collaborate with other departments, such as compliance, human resources, and finance, to address legal issues affecting hospital operations.
    • Confidentiality: Handle confidential information with discretion and maintain confidentiality of sensitive legal matters.


    Requirements

    Qualifications:
    • Education: Bachelor's degree in Paralegal Studies, Legal Studies, or related field preferred.
    • Experience:5 years experience as a paralegal, contract administration, document control specialist or similar capacity
    • License/Certification/Registry: Paralegal certificate preferred.


    Benefits

    - Competitive salary
    - Health, dental, and vision insurance
    - Retirement savings plan
    - Paid time off
    - Continuing education opportunities

  • 1 Month Ago

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Contract and Policy Specialist 1.0 FTE 7135.654
  • SPH Careers
  • Helena, MT FULL_TIME
  • JOB SUMMARY (overview of job): The Contract and Policy Specialist is responsible for ensuring consistent management of system-wide documents, such as contracts, policies and forms. This position will ...
  • 1 Month Ago

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Plant Ops - Construction Building Specialist
  • Community Medical
  • Missoula, MT FULL_TIME
  • This is a full time (0.8 - 1.0 Status), day shift Construction Building Specialist position in the Plant Ops department. Manages building program. Maintains, services, and conducts minor repairs on bu...
  • 1 Month Ago

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CPG Physical Medicine & Rehab - Clinical Service Specialist
  • Community Medical
  • Missoula, MT PART_TIME
  • This is a TPD (0.2 Status), day shift Clinical Service Specialist position in the CPG Physical Medicine & Rehab clinic. The Clinical Service Specialist is a dynamic caregiver who demonstrates excellen...
  • 1 Month Ago

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Medical Billing Specialist
  • Missoula Bone & Joint and Surgery Center
  • Missoula, MT FULL_TIME
  • Are you a problem solver with a passion for insurance and medical billing? Do you thrive in a fast-paced environment where attention to detail is crucial? Missoula Bone & Joint and Surgery Center is c...
  • 11 Days Ago

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Insurance Specialist - Medical Biller
  • Missoula Bone & Joint LLC
  • Missoula, MT FULL_TIME
  • Are you a problem solver with a passion for insurance and medical billing? Do you thrive in a fast-paced environment where attention to detail is crucial? Missoula Bone & Joint and Surgery Center is c...
  • 13 Days Ago

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0 Medical Policy Specialist jobs found in Helena, MT area

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HR Coordinator II, Leave of Absence- REMOTE
  • Ryder System Inc.
  • Helena, MT
  • Job Seekers can review the Job Applicant Privacy Policy by clicking HERE. (https://ryder.com/job-applicant-privacy-polic...
  • 4/25/2024 12:00:00 AM

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Health Technician - Ophthalmology
  • Veterans Health Administration
  • Fort Harrison, MT
  • Summary Ophthalmology Technicians in the Veterans Health Administration (VHA) perform functions such as technical clinic...
  • 4/24/2024 12:00:00 AM

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Sr. General Accounting Manager
  • Homesafe Alliance
  • Helena, MT
  • HomeSafe Alliance is the single global household goods movement manager for USTRANSCOM and the U.S. Armed Forces, Depart...
  • 4/23/2024 12:00:00 AM

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Software Engineer, Machine Learning Specialist- PyTorch Open Source
  • Facebook
  • Helena, MT
  • Summary: Facebook is seeking a data center Critical Facility Engineer to join our Data Center Facility Operations team. ...
  • 4/23/2024 12:00:00 AM

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Medical Technologist
  • Veterans Health Administration
  • Fort Harrison, MT
  • Summary This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement ...
  • 4/23/2024 12:00:00 AM

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Social Worker
  • Veterans Health Administration
  • Fort Harrison, MT
  • Summary The incumbent provides integrated treatment for patients with Substance Use Disorder, as well as a variety of ot...
  • 4/22/2024 12:00:00 AM

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Medical Technologist
  • Veterans Health Administration
  • Fort Harrison, MT
  • Summary This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement ...
  • 4/22/2024 12:00:00 AM

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Social Worker
  • Veterans Health Administration
  • Fort Harrison, MT
  • Summary The incumbent provides integrated treatment for patients with Substance Use Disorder, as well as a variety of ot...
  • 4/21/2024 12:00:00 AM

Helena (/ˈhɛlɪnə/) is the state capital of the U.S. state of Montana and the county seat of Lewis and Clark County. Helena was founded as a gold camp during the Montana gold rush, and was established in 1864. Over $3.6 billion of gold was extracted in the city limits over a duration of two decades, making it one of the wealthiest cities in the United States by the late nineteenth century. The concentration of wealth contributed to the city's prominent, elaborate Victorian architecture. At the 2010 census Helena's population was 28,190, making it the fifth least populous state capital in the Un...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$77,727 to $94,879
Helena, Montana area prices
were up 3.1% 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