Medical Policy Specialist jobs in Spartanburg, SC
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)
Recently Added Medical Policy Specialist jobs
- Watertown Regional Medical Center
-
Rutherfordton, NC
FULL_TIME
-
Description
Rutherford Regional Health System is a 143-bed acute care facility that offers a broad array of inpatient and outpatient care. Rutherford Regional is dedicated to providing patients with a full range of services to meet their healthcare needs. We provide our services in a caring, professional environment through the teamwork of our medical staff and employees.
Rutherford Regional Health System's partnership with Duke LifePoint Healthcare is bringing the pieces together to transform healthcare in Rutherford County. Duke LifePoint Healthcare is a joint venture of Duke University Health System, one of the country's leading academic health systems, and LifePoint Health, a leading healthcare company dedicated to Making Communities Healthier. These two forces joined because of the shared interest in collaborating with hospitals, healthcare providers and patients to bring high quality, innovative healthcare services to communities. Duke LifePoint combines Duke's unparalleled expertise in clinical excellence and quality care with LifePoint's extensive resources and knowledge and experience operating community hospitals and healthcare organizations.
The HR Specialist Position is responsible for coordinating the bi-weekly payroll processing and updates payroll system to reflect changes made to the employee record or status in the HRIS, assist with FMLA reporting, and collection of benefit premiums. Additionally, performs general HR administrative duties, maintains department records and files and contract files, assists employees, applicants and managers regarding HR matters. Work is of a highly confidential nature, and work other work is performed as required by the department.
Essential Functions:- Maintains Human Resources Information System (Lawson) by updating employee records and conducting audits. Provides reports as needed (i.e. Payroll Audit Reports - PA105 & PA340) for Director to approve each pay period.
- Coordinates all payroll adjustments, corrections and garnishments with Payroll Support Center.
- Completes biweekly NC new hire report and uploads data to NC Child Support Enforcement.
- Conducts file audits and maintains HR filing system.
- Participates in Employee Service Award Luncheon, Annual Holiday Reception, Annual Hospital Week Events and other employee functions as requested.
- Receives, screens, and routes visitors and telephone calls. Responds to, escalates, and follows up on inquiries and problems as appropriate.
- Composes, types, and transcribes correspondence, forms, reports, presentation materials and other written communications.
- Schedules/coordinates meetings, conferences and special events.
- Maintains files and office equipment.
QualificationsMinimum Education:- High School Diploma or equivalent required.
- Associate's Degree or Bachelor's Degree preferred.
Required Skills:- Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.
- Meditech and MS Word, Excel, PowerPoint & Outlook
- Clerical: Ability to read and understand information and ideas presented through spoken words and sentences.
- Department Specific: Ability to maintain a high level of confidentiality.
Certifications:- PHR preferred.
Minimum Work Experience:- 2-4 years HR/Payroll experience in Healthcare required.
Benefits - Wide range of benefits options!
Here at Rutherford Regional, you choose your own Medical, Dental, and Vision plans from a variety of competitive options that give you the coverage that best fits your needs.
- HSA
- 401(K) retirement plan contributions
- Generous Paid Time Off
- Accident & Critical Illness Insurance
- Prescription Assistance with OptumRx
- Income protection programs for the entire family such as life insurance, Short/Long-term Disability, and Identity Theft.
- Employee Assistance program at no cost to you to provide emotional, legal, financial, and daily life support for your entire household. Services are available 24 hrs. a day, 7 days a week.
- Free travel and entertainment discount program to ensure you enjoy your time away from work.
- Vitality Employee Wellness Plan allows you to take up to 30% off of your bi-weekly health insurance premiums. You also accrue points which allows you to buy merchandise or gift cards at no cost to you.
Why join our team?
We are dedicated to providing patients with a full range of services to meet their healthcare needs, and we believe our employees are our most valuable assets in accomplishing this goal. Rutherford Regional is growing its team of dedicated health care professionals. If you are looking to start a career that cares, are passionate about changing lives, and ready to work in a supportive environment in a close-knit community, apply today!
Job Human ResourcesPrimary Location NC-RutherfordtonSchedule Full-timeWork Schedule Day shift, 7-10 hr/shift, weekdays only - 14 Days Ago
- Watertown Regional Medical Center
-
Rutherfordton, NC
FULL_TIME
- Rutherford Physician PracticesDescription Company Description: Rutherford Regional Health System is a 143-bed acute care facility that offers a broad array of inpatient and outpatient care. Rutherford...
- 16 Days Ago
- Spartanburg and Greer Ear, Nose, and Throat
-
Spartanburg, SC
FULL_TIME
- POSTION SUMMARY: Files electronic and paper primary and secondary claims daily. Corrects rejected claims and resubmits. Posts insurance and mail payments. Codes and posts surgery/procedures performed ...
- 3 Days Ago
- Coast Medical Service
-
Spartanburg, SC
FULL_TIME
- Coast Medical Service is a nationwide travel nursing & allied healthcare staffing agency dedicated to providing an elite traveler experience for the experienced or first-time traveler. Coast is featur...
- 2 Days Ago
- North Carolina Adult Correction
-
Columbus, NC
FULL_TIME
- Description of Work Position is a Medical Records Assistant (Administrative Specialist I) located at Tabor Correctional in Tabor City, NC. Employees at this level independently will perform a variety ...
- Just Posted
- State of North Carolina
-
Columbus, NC
FULL_TIME
- Position is a Medical Records Assistant (Administrative Specialist I) located at Tabor Correctional in Tabor City, NC. Employees at this level independently will perform a variety of tasks within spec...
- 4 Days Ago
- Current Active Filter
- Spartanburg, SC
Clear All
- Filter Jobs By posted time
- Within 1 Day
- Within 2-7
- Within 1 Month
- Within 3 Months
0 Medical Policy Specialist jobs found in Spartanburg, SC area
- Agape Care Group
-
Spartanburg, SC
- Overview: Become a Medical Billing Specialist with Agape Care Group We are looking for a highly skilled medical billing ...
- 4/25/2024 12:00:00 AM
- Tenet Health
-
Piedmont, SC
- Job Description This role provides direct clinical patient care with Tenet's in-house contingent Pool, Trusted Resource ...
- 4/25/2024 12:00:00 AM
- Bright Horizons Family Solutions
-
Spartanburg, SC
- Imagine your future teaching with a world-class team where you make a difference for children every day. Imagine learnin...
- 4/24/2024 12:00:00 AM
- Spartanburg Regional Medical Center
-
Spartanburg, SC
- Position Summary The Operations Manager for Oncology Services serves as the lead expert in data analytics, process impro...
- 4/23/2024 12:00:00 AM
- Spartanburg Regional Medical Center
-
Spartanburg, SC
- Position Summary The Cardiac Cath Technologist # Registered, under the direction of the Cardiac Cath / EP Lab manager, i...
- 4/22/2024 12:00:00 AM
- The Gap
-
Spartanburg, SC
- About Old Navy Forget what you know about old-school industry rules. When you work at Old Navy, you're choosing a differ...
- 4/22/2024 12:00:00 AM
- Snider Fleet Solutions
-
Spartanburg, SC
- People who want to do a great job want to work for a company that values that dedication. We do. Snider Fleet Solutions ...
- 4/22/2024 12:00:00 AM
- Bright Horizons Family Solutions
-
Spartanburg, SC
- Imagine your future teaching with a world-class team where you make a difference for children every day. Imagine learnin...
- 4/22/2024 12:00:00 AM
About Spartanburg, South Carolina
were up 1.5% from a year ago