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)
Together. We Grow. For over 95 years, Pikeville Medical Center has worked to be the healthcare provider and employer of choice in Eastern Kentucky and across the broader region we serve. With approximately 3,000 employees and 500 credentialed providers who represent more than 45 home counties in Kentucky, Virginia and West Virginia, Pikeville Medical Center focuses on providing top-quality patient care in a Christian environment.
We are inclusive, intentionally creating a culture of acceptance where all are valued and respected for who they are. We foster teamwork knowing that collaboration paves the way in our pursuit of excellence in all that we do.
We also believe in providing opportunities for members of our team to grow in their careers. Pikeville Medical Center would like to provide that opportunity to you as a member of our Recruitment Services Department. Will you be the next to join our growing team?
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0 Medical Policy Specialist jobs found in Huntington, WV area