Medical Policy Specialist jobs in Peoria, IL

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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Admitting Specialist
  • Hopedale Medical Complex
  • Hopedale, IL FULL_TIME
  • Admitting/Registration Clerk

    HMC Offers:

    • Nursing Scholarships
    • Loan Forgiveness
    • Tuition Reimburse
    • Excellent benefits
    • Quality childcare located in Hopedale
    • Wellness Center membership
    • 401(k) plan with employer match

    Employee Daycare Rates

    • Infants (6 weeks to 15 months) - $133 weekly, $27 daily
    • Toddlers (15 months to 2 yrs) - $126 weekly, $26 daily
    • 2 years to 3 years - $119 weekly, $25 daily
    • 4 years to 5 years - $112 weekly, $23 daily

    Job Preview

    The Admitting/Registration Clerk is a patient's first point of contact at the hospital. Must be able to handle the duties of both a receptionist and medical secretary, signing in people and dealing with their personal information. Admitting/Registration Clerk particularly need the skills to collect and organize information to keep the flow of patients running smoothly.

    Responsibilities

    • Greet all patients and answer all incoming phone calls, promoting quality customer service.
    • Record patient demographic information, insurance, and billing information into the CPSI computer system; research missing information and obtains signatures on required forms.
    • Counsel patients and families regarding financial issues such as insurance.
    • Provide information to the patient/representative about billing, complaint process, patient rights and visiting hours. Distribute hospital specific literature.
    • Collect and record payments and/or forward information to the Patient Accounts Department personnel.
    • Maintain orders sent to the hospital by referring offices.
    • Compile an estimate of patient payment responsibility for their services and communicate this information to the patient.
    • Is familiar with the HMC payment policies and various options for payment and the financial assistance program.
    • Screen calls to ascertain nature and urgency of inquiry.
    • Keep the waiting area orderly throughout the day.
    • Order and maintain supplies as required.
    • Treat patients and their families with respect and dignity.
    • Ensure confidentiality of patients' information
    • Performs other related work as required or requested.

    Background and Drug screen Disclaimer:

    All HMC employees are required to pass a Federal and State background check and pass a drug and alcohol test. We test for illegal and legal substances, including marijuana.

    Requirements:

    • High school diploma or the equivalent is required.
    • Some college coursework is preferred.
    • Experience in medical office reception is required.
    • Knowledge of medical terminology is required.
    • Awareness of patient registration and documentation procedures is required.
    • Strong telephone communication skills, often in stressful situations, are required.
    • Ability to analyze and solve problems are required.
    • Proficiency with personal computers and Microsoft Office Suite is required.
    • Ability to type 35-45 wpm is preferred.
    • Good verbal and written communication skills are required.
    • Knowledge of basic insurance procedures and documentation of third-party medical insurance payers is required.
    • Ability to work independently with only general supervision is required.
    • Flexibility, organizational skills, and ability to function well under stress are required.

    Job Type: Full-time

    Pay: From $15.00 per hour

    Benefits:

    • 401(k)
    • 401(k) matching
    • Dental insurance
    • Disability insurance
    • Health insurance
    • Life insurance
    • Paid sick time
    • Paid time off
    • Tuition reimbursement
    • Vision insurance

    Healthcare setting:

    • Outpatient

    Medical specialties:

    • Hospital Medicine

    Schedule:

    • Day shift
    • Monday to Friday

    Ability to Relocate:

    • Hopedale, IL 61747: Relocate before starting work (Required)

    Work Location: In person

  • 8 Days Ago

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Medical Billing Specialist
  • Keplr Vision
  • Bloomington, IL FULL_TIME
  • Summary/Objective The Medical Billing Specialist is responsible for timely and accurate billing of all medical claims for a vision care practice. This position requires working with insurance companie...
  • 1 Day Ago

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Medical Coder/Billing Specialist
  • Jody L. Kelly, M.D. & Associates
  • Peoria, IL FULL_TIME
  • Jody L. Kelly, M.D. & Associates is looking for a Medical Coder/Billing Specialist The position is a four/five day work week Job qualifications: Education and experience required 3 to 5 years experien...
  • 1 Day Ago

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Medical Coder/Billing Specialist
  • A Cleaner Finish, LLC
  • Peoria, IL FULL_TIME
  • Education & experience required High School graduate Certified Professional Coder 3 to 5 years experience with medical billing and /or accounts receivable Experience with OB/GYN CPT and ICD-10 coding ...
  • 1 Day Ago

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IT Helpdesk Specialist
  • Hopedale Medical Complex
  • Hopedale, IL FULL_TIME
  • IT Helpdesk Specialist The IT Help Desk Specialist provides fast and effective support to our clients. As a Help Desk Specialist, you will be required to respond to queries in person and over the phon...
  • 1 Month Ago

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Enviromental Policy Coordinator
  • Illinois Soybean Board
  • Bloomington, IL FULL_TIME
  • Illinois Soybean Association (ISA) is a statewide organization that strives to enable Illinois soybean producers to be the most knowledgeable and profitable soybean producers in the world. The Environ...
  • 8 Days Ago

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0 Medical Policy Specialist jobs found in Peoria, IL area

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CMA - Methodist Hospital Surgical
  • Carle Health
  • Peoria, IL
  • Job Details CMA - Methodist Hospital Surgical Department: Surgical 4H- CMH Usual Schedule: 12 hour shifts Regions: On Ca...
  • 4/25/2024 12:00:00 AM

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CMA - Methodist Oncology Clinic
  • Carle Health
  • Peoria, IL
  • Job Details CMA - Methodist Oncology Clinic Department: Oncology - CMH Usual Schedule: M-F 800am-430pm Regions: On Call ...
  • 4/25/2024 12:00:00 AM

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Distinguished Engineer - Card Modernization
  • Capital One
  • Peoria, IL
  • Center 1 (19052), United States of America, McLean, Virginia Distinguished Engineer - Card Modernization As a Distinguis...
  • 4/25/2024 12:00:00 AM

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Principal Associate, Business Risk
  • Capital One
  • Peoria, IL
  • Center 3 (19075), United States of America, McLean, Virginia Principal Associate, Business Risk Security is essential to...
  • 4/25/2024 12:00:00 AM

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RN- Neurology Clinic
  • Carle Foundation Hospital
  • Peoria, IL
  • * Clinical Excellence/Patient CareAssist provider and other clinical staff with obtaining basic vital information prepar...
  • 4/23/2024 12:00:00 AM

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Nurse Practitioner - Advanced Practice Provider
  • Oak Street Health Inc.
  • Peoria, IL
  • Title: Nurse Practitioner - Advanced Practice Provider Schedule: Full-Time, Monday through Friday, 8:00 AM - 5:00 PM Loc...
  • 4/22/2024 12:00:00 AM

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Phlebotomist
  • Grifols SA
  • Peoria, IL
  • Do you want to join an international team working to improve the future of healthcare? Do you want to improve the lives ...
  • 4/22/2024 12:00:00 AM

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EMT
  • Grifols
  • Peoria, IL
  • Would you like to join an international team working to improve the future of healthcare? Do you want to enhance the liv...
  • 4/13/2024 12:00:00 AM

Peoria (/piˈɔːriə/ pee-OR-ee-ə) is the county seat of Peoria County, Illinois, and the largest city on the Illinois River. Established in 1691 by the French explorer Henri de Tonti, Peoria is the oldest European settlement in Illinois, and is named after the Peoria tribe. As of the 2010 census, the city was the seventh-most populated in Illinois (and the third largest outside the Chicago metropolitan area), with a population of 115,007. The Peoria Metropolitan Statistical Area had a population of 373,590 in 2011. Until 2018, Peoria was the global and national headquarters for Caterpillar Inc.,...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$86,046 to $105,033
Peoria, Illinois area prices
were up 1.3% 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