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)
This position is exposed to a variety of areas of law and work across all divisions of the Department of Environment, Great Lakes, and Energy. The position works under the direction of the Legal Specialist in the Information Management Division and assists with various legal issues of the Department. The position assists in managing the litigation holds for the Department. Additionally, the position assists with discovery, subpoena response, Freedom of Information Act (FOIA) requests, and legal research.
This position requires current enrollment in Law School.
The selected candidate may be eligible for a hybrid work schedule (combination of remote and in-person) or a fully remote work schedule (with occasional travel to their official work location). Employees approved for schedules that include remote work must complete that work within Michigan. Relocation expenses are not reimbursed. When working remote, employees must use a designated workspace that is safe and professionally appropriate, allows for privacy, minimizes distractions, and includes secure internet access. Details regarding work location and schedule options for this position may be discussed during the interview process.
ABOUT EGLE
The Department of Environment, Great Lakes, and Energy's mission is to protect Michigan’s environment and public health by managing air, water, land, and energy resources.