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)
Position: Policy Specialist
Location: Hybrid
Contract: 5 Months
Position Description
This position works as part of team writing and revising policy and procedure documents for the Division of Developmental Disabilities related to operations of the agency, services provided to the public, and compliance with contractual obligations. This position is also responsible for researching policy topics, working with subject matter experts to ensure policy and procedures are up to date and meeting the agency's needs, and cross comparing agency policy with ***policy to ensure agency policy is aligned with ***.
Skills Required
1. Ability to write concise formal documents following a prescribed format. 2. Ability to research and cross compare policy documents to determine differences and potentially needed changes to align the documents. 3. Ability to take information from Subject Matter Experts and document it in a prescribed policy format.
Experience Required
Experience writing formal documents. Experience researching complex issues.
Experience Preferred
Experience writing governmental or healthcare policy.
Job Type: Contract
Salary: Up to $26.00 per hour
Expected hours: 40 per week
Schedule:
Work setting:
Work Location: In person
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