Medical Policy Specialist jobs in Rhode Island

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)

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Medical Billing Specialist - Full Time
  • New England Medical Billing
  • Rumford, RI FULL_TIME
  • New England Medical Billing is seeking a detail-oriented, reliable and independent worker with a minimum of 1-2 years experience with insurance follow up and denial management to assist with accounts receivable follow up for a high volume surgical practice.

    Duties include all aspects of medical, third party billing, including but not limited to: charge entry, registration updates, payment collection, answering phone calls, assisting with patients, claims follow up.

    Job Requirements:

    · Must possess strong organizational skills, be detail oriented and self motivated, and have excellent verbal and written communication skills.

    · Previous experience in physician billing, surgical preferred.

    · Knowledge of CPT, modifiers and ICD-10 codes necessary.

    · Computer knowledge: Microsoft Word & Excel, Billing software (IDX preferred), EMR knowledge.

    Health, dental and retirement available. Salary commensurate with experience. Qualified applicants should submit a cover letter with salary requirements

    Job Type: Full-time

    Pay: $18.00 - $20.00 per hour

    Benefits:

    • 401(k)
    • Dental insurance
    • Health insurance
    • Paid time off

    Schedule:

    • 8 hour shift
    • Monday to Friday

    Education:

    • High school or equivalent (Preferred)

    Experience:

    • Medical billing: 1 year (Preferred)

    Work Location: In person

  • 3 Days Ago

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Policy Associate
  • ACLU - Affiliate Offices
  • Providence, RI FULL_TIME
  • The American Civil Liberties Union of Rhode Island is seeking a Policy Associate. The duties for this in-office position involve working on, and assisting the Executive Director in, various day-to-day...
  • 2 Days Ago

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Policy Administrator
  • TEKsystems
  • North, RI FULL_TIME
  • Job Description:Performs administrative functions required for servicing of insured policy, certificate issue, and premium billing/collectionProcess enrollment, terminations, plan changes, census chan...
  • 2 Months Ago

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CHIEF MEDICAL CARE SPECIALIST
  • State of Rhode Island
  • Providence, RI OTHER
  • GENERAL STATEMENT OF DUTIES: To be responsible for assisting the Medical Care Program Director in the planning and administration of a state-wide medical care program for eligible recipients of medica...
  • 2 Days Ago

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Medical Transport Specialist / Driver
  • Quest Diagnostics
  • Johnston, RI FULL_TIME
  • Overview Medical Transport Specialist / Driver Johnston, RI - Monday-Friday 5:00pm-1:30am We will provide you a career with a leader in the healthcare industry, by offering a wide variety of opportuni...
  • 4 Days Ago

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Medical Billing Specialist
  • Aquidneck Pediatrics, LLC.
  • Middletown, RI FULL_TIME
  • Responsibilities Complete daily eligibility workflow to ensure active coverage and correct assignment to Primary Care Provider (PCP) Electronic claims submission. Review of claims to ensure coding sta...
  • 4 Days Ago

Rhode Island (/ˌroʊd -/ (listen)), officially the State of Rhode Island and Providence Plantations, is a state in the New England region of the United States. It is the smallest state in area, the seventh least populous, the second most densely populated, and it has the longest official name of any state. Rhode Island is bordered by Connecticut to the west, Massachusetts to the north and east, and the Atlantic Ocean to the south via Rhode Island Sound and Block Island Sound. It also shares a small maritime border with New York. Providence is the state capital and most populous city in Rhode Is...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$93,816 to $114,511

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