Medical Policy Specialist jobs in Raleigh, NC

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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Nurse Practitioner
  • Specialist Office
  • Wilson, NC FULL_TIME
  • Nurse Practitioner or Physician Assistant – Oncology
    Wilson, North Carolina

    MUST:
    Registered Nurse Practitioner or Physician Assistant
    Must have 2-3 years of NP/PA experience
    Oncology experience required
    Graduate from an accredited Nurse Practitioner program, Masters Degree in Nursing
    Current license/registration to practice in the state of NC
    CPR certification
    Advanced Oncology Nurse Certification preferred

    DUTIES:
    The candidate will perform the important task of educating patients about preventative care and prescribed treatments related to cancer care.
    Conduct physicals; order tests schedule the infusions in the treatment of the patients care.
    Provide diagnosis, treatment, consultation, and follow up care of patients corresponding with the appropriate level of training.
    Prevention of illness and disability.
    Management of illness and disability.
    Diagnosing, treating, and managing acute and chronic illness.
    Guidance and counseling of individuals and families.

    *Quadrant, Inc. is an equal opportunity and affirmative action employer. Quadrant is committed to administering all employment and personnel actions on the basis of merit and free of discrimination based on race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or status as an individual with a disability. Consistent with this commitment, we are dedicated to the employment and advancement of qualified minorities, women, individuals with disabilities, protected veterans, persons of all ethnic backgrounds and religions according to their abilities.

  • 14 Days Ago

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Lawn Specialist
  • TruGreen - Lawn Specialist - Cary, NC
  • Franklinton, NC FULL_TIME
  • TruGreen is Hiring Residential Lawn SpecialistsImmediate Openings in Cary, NCAt TruGreen, we are committed to our customers, our teams, our values, and the science of lawn care. A career with TruGreen...
  • 1 Day Ago

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Medical Technology (MT) Specialist - Pathology - Flow Cytometry
  • ECU Health Medical Center
  • Greenville, NC FULL_TIME
  • ECU Health About ECU Health ECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system ...
  • Just Posted

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Specialist medical
  • Grifols
  • Greenville, NC FULL_TIME
  • Would you like to join an international team working to improve the future of healthcare? Do you want to enhance the lives of millions of people? Grifols is a global healthcare company that since 1909...
  • 20 Days Ago

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Policy Analyst
  • TRC Talent Solutions
  • Raleigh, NC FULL_TIME
  • TRC’s client is an established insurance company that provides various product lines such as home, auto, farm, commercial, marine, personal property, and more. With a strong emphasis on community, col...
  • 17 Days Ago

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Clinical Specialist
  • Zoll Medical Corporation
  • Raleigh, NC FULL_TIME
  • Clinical Specialist Location: Placeholder, NC, United States of America Respicardia At ZOLL, we're passionate about improving patient outcomes and helping save lives. We provide innovative technologie...
  • Just Posted

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0 Medical Policy Specialist jobs found in Raleigh, NC area

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Claims Examiner -Remote
  • Generis Tek Inc
  • Raleigh, NC
  • Please Contact: To discuss this amazing opportunity, reach out to our Talent Acquisition Specialist Abhinav Chakraborty ...
  • 4/25/2024 12:00:00 AM

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E-Commerce Marketing Associate (Creative) (Hybrid Remote) (Entry-Level)
  • Reli.
  • Raleigh, NC
  • Reli. is a rapidly growing eCommerce company selling on Amazon (www.amazon.com/reli), Walmart, Shopify (ShopReli.com), a...
  • 4/25/2024 12:00:00 AM

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Director of Specialty Bill Review Services - Remote
  • Rising Medical Solutions
  • Raleigh, NC
  • As our Director of Specialty Bill Review Services, you will maximize savings and client satisfaction by providing strate...
  • 4/25/2024 12:00:00 AM

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VP of Clinical Development, Neurogenetic Diseases
  • SEC Life Sciences
  • Raleigh, NC
  • An innovator in the gene therapy space is seeking a Vice President (VP) of Clinical Development specializing in Neurogen...
  • 4/24/2024 12:00:00 AM

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REMOTE: Medical Director, Utilization Management and Medical Policy
  • Evry Health
  • Raleigh, NC
  • About the Role Evry Health is hiring a tech-savvy Medical Director to lead medical policy and utilization management. As...
  • 4/24/2024 12:00:00 AM

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Chief Technology Officer (CTO)
  • HomeSafe Alliance
  • Raleigh, NC
  • Title: Chief Technology Officer (CTO) HomeSafe Alliance is the exclusive household goods move manager for U.S. military ...
  • 4/24/2024 12:00:00 AM

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Claims Examiner –Remote
  • Generis Tek Inc
  • Raleigh, NC
  • Please Contact: To discuss this amazing opportunity, reach out to our Talent Acquisition Specialist Abhinav Chakraborty ...
  • 4/23/2024 12:00:00 AM

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Principal Mechanical Engineer - Fire Suppression (Onsite)
  • Raytheon Technologies
  • Raleigh, NC
  • Date Posted:2024-01-22Country:United States of AmericaLocation:HNC14: Kidde Aerospace - Raleigh 3120 Highwoods Blvd, Sui...
  • 4/23/2024 12:00:00 AM

According to the United States Census Bureau, Raleigh occupies a total area of 144.0 square miles (373.0 km2), of which 142 square miles (369 km2) is land and 0.97 square miles (2.5 km2), or 0.76%, is covered by water. The Neuse River flows through the northeast end of the city. Raleigh is located in the northeast central region of North Carolina, where the Piedmont and Atlantic Coastal Plain regions meet. This area is known as the "fall line" because it marks the elevation inland at which waterfalls begin to appear in creeks and rivers. As a result, most of Raleigh features gently rolling hil...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$87,208 to $106,453
Raleigh, North Carolina area prices
were up 1.5% 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