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)
Intercoastal Medical Group, Inc. is seeking an experienced Medical Claims Denial Specialist for a multispecialty practice. The specialist is responsible for managing claim denials, submitting medical records to the insurance carrier, processing explanation of benefits (EOB), communicating with the treating provider or office coordinator on claim issues, and re-submitting claims.
Intercoastal is a drug free workplace and EEO compliant.
Requirements:
*High School Diploma or Equivalent
*Current Medical Billing Experience
*Completion of Medical Coding Course a plus
*Basic HIPAA Knowledge
*Strong Computer Skills
Job Type: Full-time
Pay: From $18.00 per hour
Benefits:
Schedule:
People with a criminal record are encouraged to apply
Education:
Experience:
Work Location: In person
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