Medical Policy Specialist jobs in Santa Ana, 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)

A
Accounting Specialist
  • Autonomous Medical Devices Inc.
  • Sunflower, CA FULL_TIME
  • Autonomous Medical Devices Incorporated (AMDI) is an early-stage, California company focused on developing and manufacturing Autolabs and their associated test discs for human clinical diagnostics. Each of AMDI’s Autolabs are small, portable point-of-care diagnostics devices using breakthrough microfluidics, hardware, and data/cloud connectivity to deliver secure lab quality results in <15 minutes. AMDI has built a world class, multi-disciplinary team of engineers, scientists, clinicians, and database experts and will launch its first Research Use Only (RUO) products in 2023 from its ISO 13485 certified 110,000 square foot facility in Santa Ana, CA.

     

    Summary of Position

    This role is responsible for payables and purchasing.  This includes controlling expenses at time of requisition, physical receipt and subsequently receiving, returning, processing, verifying, and coding invoices/credit memos. 

     

    Essential Duties and Responsibilities

    •  Creates purchase orders from user requisition.
           Confers with vendors to obtain information such as terms, price, availability, and delivery schedule.
           Compares purchase orders, prices, terms of payment and other charges against packing slips and vendor bills.
           Reviews proper accounting period, expense, and department coding.
           Record and reconcile P-card transactions.
           Ensures purchase orders and other bills are processed in a timely and accurate manner.
           Develop training manual and train new users.
           Run reports on open PO’s and reconcile for month-end close.
      Receives purchase orders and processes into NetSuite
           Verify packing slips contain date and signatures physically received from individual who purchased the items. 
           Scan in packing slips to send to receiving email and receives items in NetSuite
           Discusses defective or unacceptable goods or services with inspection or quality control personnel, users, vendors, and others to determine source of trouble and take corrective action including obtaining credits and returns with supplier.
      Processes accounts payable of 3-way match and standalone invoices and credits using NetSuite.
      Scan invoices and upload invoices into Advance Bill Management and route for approvals. 
      Establish and maintain relationships with new and existing vendors.
           Modify vendor records in vendor Master file:
           Review W-9s and ensure proper 1099 classifications.
           Verify banking information following best practices to ensure 100% accuracy.
      Identify buyers and complete the sale of excess inventory as required.
      Provide support coverage for other members of the Finance and Human Resource teams when they are not available
      Additional projects and/or duties as assigned
      Full-time onsite work at our Santa Ana location to fulfill the administrative functions referenced above such as scanning in packing slips, scanning in invoices and providing support coverage to other members such as answering the lobby door or helping with shipping packages.

     

    Qualifications Required for Position

    •      Minimum of an Associate degree in Business, Accounting, Finance, or equivalent.
      •    Minimum of 3 years of related experience – manufacturing experience a plus.
      •    Excellent computer skills with proficiency in Microsoft Office Suite (Excel, Word, PowerPoint, and Outlook) and Microsoft Teams or Zoom
      •    Experience with NetSuite is highly preferred.
      •    Well organized, analytical, and strong attention to detail.
      •    Ability to maintain the highest level of discretion, diplomacy, and confidentiality in all dealings with vendors.

     

    Desired skills and traits

    •      Someone who gets things done without perfect resources, is innovative, and works with a sense of urgency.
      •    Results oriented – drives progress & excellence.
      •    Effective interpersonal and communication skills. 
      •    Contributes to a collaborative and inclusive work environment.
      •    Someone who has high standards, takes ownership, and is invested in the outcome.
      •    Someone who proactively helps others, stays positive and has a good sense of humor.

     

    Work Environment

    •      Full-time onsite at our Santa Ana location, indoor at a manufacturing facility.
      •    Prolonged periods at a desk and working on a computer.
      •    Must be able to lift 25 pounds at times.

     

    Autonomous Medical Device Incorporated offers a comprehensive compensation and benefits package to eligible employees including:

    Company provided lunch to all employees when working at one of AMDI’s on-site locations.

    - 401(k) match

    - Health insurance, 100% paid for by employer including: Medical, Dental, Vision & Life Insurance

    - Competitive vacation, sick days & paid holidays

    - Tuition reimbursement

    - Casual dress code

    - Employee discounts on activities such as theme parks, movie theaters, hotels, rental cars, etc.

    - Monthly company-wide social

     

    Autonomous Medical Devices Incorporated (AMDI) will not accept unsolicited resumes from any source other than directly from a candidate. An Agency must obtain advance written approval from AMDI’s internal Human Resources team to submit resumes only in conjunction with approved valid fully executed contracts. We are not currently entertaining Staffing agency assistance for this position.

     

    Our commitment to an inclusive workplace:

    We are an equal opportunity employer and encourage people from all backgrounds to apply.  All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability, protected veteran status, or any other protected characteristic under federal, state, or local law.

  • 2 Days Ago

V
Veterinary Technician-OVERNIGHT/SWING SHIFTS
  • Veterinary Surgical Specialist of Orange County
  • Tustin, CA FULL_TIME
  • DescriptionLooking to make a difference?Be part of a highly skilled team?Be a part of an innovative surgical and urgent care hospital!Overnight Technicians Needed!!We have a position for you with comp...
  • 20 Days Ago

V
Internal Medicine RVT
  • Veterinary Surgical Specialist of Orange County
  • Tustin, CA FULL_TIME
  • DescriptionLooking to make a difference?Be part of a highly skilled team?Be a part of an innovative Surgical/Urgent Care/Internal Medicine Practice!We have a position for you with competitive wages an...
  • 14 Days Ago

V
Veterinary Client Care Representative
  • Veterinary Surgical Specialist of Orange County
  • Tustin, CA FULL_TIME
  • DescriptionJob descriptionLooking to make a difference?Be part of a highly skilled team?Provide essential services for fur-family members and their parents?We have a position for you with competitive ...
  • 28 Days Ago

M
Medical Billing Specialist
  • Michael Fishman DPM INC
  • Los Alamitos, CA FULL_TIME
  • We are a busy Podiatry office located in Los Alamitos, CA, looking to hire a Medical Biller who will work under "1" doctor. We are looking for someone who will demonstrate a professional, helpful, and...
  • 2 Days Ago

C
Medical Billing and Collections Specialist
  • Coastline Orthopaedic Associates
  • Fountain Valley, CA FULL_TIME
  • Coastline Orthopaedic Associates is looking for a qualified medical biller. Apply today!1 year(s) medical billing experience preferred.A Medical Biller, or Insurance Billing Specialist, is responsible...
  • 1 Month Ago

Filters

Clear All

Filter Jobs By Location
  • Filter Jobs by companies
  • More

0 Medical Policy Specialist jobs found in Santa Ana, CA area

P
Family Practice Physician Needed in Southern Orange County
  • Provider Healthcare
  • Orange County, CA
  • Job Description Job Description Job Type – Full Time Schedule - Days Pay – From $240,000 - $260,000 annually plus incent...
  • 4/26/2024 12:00:00 AM

G
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

E
REMOTE: Medical Director, Utilization Management and Medical Policy
  • Evry Health
  • Irvine, CA
  • 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

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

O
Medical Assistant Back Office
  • OC UROLOGY
  • Santa Ana, CA
  • Job Description Job Description Responsibilities Our Medical Assistants greet our patients, obtain their medical histori...
  • 4/23/2024 12:00:00 AM

G
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

G
Mobile Phlebotomist - PT - Anaheim, CA
  • Getlabs
  • Anaheim, 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

A
Medical Malpractice Attorney
  • Ascendion
  • Glendale, CA
  • Looking for a Medical Malpractice Attorney, who will be responsible for managing all aspects of legal proceedings for cl...
  • 4/22/2024 12:00:00 AM

Santa Ana /ˌsæntə ˈænə/ (Spanish for "Saint Anne") is the county seat and second most populous city in Orange County, California in the Los Angeles metropolitan area. The United States Census Bureau estimated its 2011 population at 329,427, making Santa Ana the 57th most-populous city in the United States. Santa Ana is in Southern California, adjacent to the Santa Ana River, about 10 miles (16 km) from the coast. Founded in 1869, the city is part of the Greater Los Angeles Area, the second largest metropolitan area in the United States, with almost 18 million residents in 2010. Santa Ana is a ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$99,015 to $120,865
Santa Ana, California area prices
were up 2.5% 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