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)
Ankle & Foot Specialist of NJ is a growing podiatric practice with multiple locations. Established in 2005, we pride ourselves in providing the highest standard of care to our patients with detailed orientation to customer service and quality control.
We are currently seeking a highly motivated, detail oriented and driven individual with excellent customer service and communication skills. The billing specialist is responsible for -
* Entering charges accurately to ensure fast payment responses,
* Ensuring timely management of unpaid claims, and/or denials from insurances and/or clearing house,
* Correcting claim errors in a timely manner,
* Researching and appealing denied claims; submit requested documentation as needed,
* Payment posting in a timely manner,
* Monthly reports to management and notifying management of any trends identified,
* Insurance Verifications and prior authorizations,
* Reviewing patient statements for accuracy
* Ensuring strict confidentiality of financial records in accordance with HIPAA guidelines
Skills/Experience
· Knowledge of medical billing/coding required preferably in Podiatry.
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Job Type: Full-time
Pay: $28.00 - $35.00 per hour
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Work Location: In person