Medical Policy Specialist jobs in San Bernardino, CA

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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Program specialist
  • Loma Linda University Medical Center
  • San Bernardino, CA FULL_TIME
  • Shared Services : Risk Management-(Full-Time, Day Shift) -

    Job Summary : The Wellness Program Specialist supports the wellness program; provides customer service and monitors employee wellness activities / requirements.

    Aids in scheduling, reminders and care follow-up; maintains and organizes records / data. Employee must be an organized team player with good written and verbal communication skills.

    Must be able to take direction and receive feedback. Performs other duties as needed.

    Education and Experience : High School Diploma or GED required. Associate's Degree preferred. Minimum three years of secretarial / general office or project management experience required.

    Knowledge and Skills : Must know the mission and values of the organization and have a working knowledge of Living Whole programs.

    Able to read; write legibly; speak in English with professional quality; use computer, printer, and software programs necessary to the position (e.

    • g., Word, Excel, Outlook, PowerPoint). Operate / troubleshoot basic office equipment required for the position. Able to relate and communicate positively, effectively, and professionally with others;
    • work calmly and respond courteously when under pressure; collaborate and accept direction. Able to communicate effectively in English in person, in writing, and on the telephone;
    • think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve;
    • recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Able to distinguish colors as necessary;
    • hear sufficiently for general conversation in person and on the telephone, and identify and distinguish various sounds associated with the workplace;

    see adequately to read computer screens, and written documents necessary to the position.

    Licensures and Certifications : Valid Driver's License required at time of hire.

    Last updated : 2024-03-22

  • 1 Month Ago

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Medical Biller/Collections Specialist
  • Robert Half
  • Rancho Mirage, CA PER_DIEM
  • We are providing an opening for a Medical Biller/Collections Specialist within the healthcare and social assistance industry, specifically in the Rancho Mirage, California area. This role offers a con...
  • Just Posted

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Medical Collections Specialist
  • TEKsystems
  • San Bernardino, CA FULL_TIME
  • Description:The Collector performs A/R collections and billing involving multiple insurance contracts & entities. Analyzes and audits accounts for correct balance, proper follow-up and complete reimbu...
  • 1 Month Ago

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Policy & Prevention Program Coordinator
  • Reach Out West End Inc.
  • Yucca Valley, CA FULL_TIME
  • Position Description The Policy and Prevention Program Coordinator has an emphasis on project and program management related to development and implementation of policies focused on reducing substance...
  • 10 Days Ago

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Health Policy Analyst
  • Loma Linda University Health
  • Loma Linda, CA FULL_TIME
  • Shared Services: Health Policy and Leadership - (Full-time, Day Shift) - Our mission is to continue the teaching and healing ministry of Jesus Christ. Our core values are compassion, excellence, humil...
  • 26 Days Ago

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Health Policy Analyst Sr
  • Loma Linda University Health
  • Loma Linda, CA FULL_TIME
  • Shared Services: Health Policy and Leadership - (Full-time, Day Shift) - Our mission is to continue the teaching and healing ministry of Jesus Christ. Our core values are compassion, excellence, humil...
  • 26 Days Ago

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0 Medical Policy Specialist jobs found in San Bernardino, CA area

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Driver, Shuttle CDL Class B
  • InnovAge
  • San Bernardino, CA
  • Responsibilities Caring Shuttle Driver to transport our frail senior patients InnovAge Drivers provide transportation fo...
  • 4/26/2024 12:00:00 AM

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Pilot (IFR) Rotor Wing - Victorville, CA
  • Justhelicopters
  • Victorville, CA
  • **Pilot (IFR) Rotor Wing - Victorville, CA** Experience Required Yes Job Description **Competitive Pilot Compensation - ...
  • 4/26/2024 12:00:00 AM

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Renewable Energy Environmental Planner/Permitting Specialist
  • Stantec
  • San Bernardino, CA
  • Renewable Energy Environmental Planner/Permitting Specialist - ( 230002KA ) Description Grounded in safety, quality, and...
  • 4/26/2024 12:00:00 AM

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Pediatrician
  • Community Health Systems, Inc.
  • Bloomington, CA
  • Job Description Job Description ESSENTIAL DUTIES AND RESPONSIBILITIES: 1. Upholds and supports the mission, philosophy, ...
  • 4/25/2024 12:00:00 AM

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Claims Examiner -Remote
  • Generis Tek Inc
  • Irvine, CA
  • 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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Pilot Fixed Wing
  • REACH Medical Holdings
  • Murrieta, CA
  • Job Description: NOW HIRING - King Air Pilot - Murrieta, CA $107,256 - $117,982 (Equals base plus 25% Geo Modifier) $15K...
  • 4/24/2024 12:00:00 AM

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Instructional Tutor - Deaf and Hard of Hearing (DHH)
  • San Bernardino City Unified School District
  • San Bernardino, CA
  • Salary: $22.95 - $27.92 Hourly Location : San Bernardino City Unified School District, CA Job Type: Most positions work ...
  • 4/24/2024 12:00:00 AM

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Mobile Phlebotomist - PT - Orange, CA
  • Getlabs
  • Orange, CA
  • Getlabs is the nationwide leader for at-home diagnostics. Healthcare organizations use our all-in-one technology platfor...
  • 4/23/2024 12:00:00 AM

According to the United States Census Bureau, the city has a total area of 59.6 square miles (154 km2), of which 59.2 square miles (153 km2) is land and 0.4 square miles (1.0 km2), or 0.74%, is water. The city lies in the San Bernardino foothills and the eastern portion of the San Bernardino Valley, roughly 60 miles (97 km) east of Los Angeles. Some major geographical features of the city include the San Bernardino Mountains and the San Bernardino National Forest, in which the city's northernmost neighborhood, Arrowhead Springs, is located; the Cajon Pass adjacent to the northwest border; City...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$94,453 to $115,296
San Bernardino, California area prices
were up 3.0% 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