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)
Coastal Fertility Specialists (CFS) consists of 5 clinical and 2 administrative offices and over 110 employees including RN's, NP's, 5 physicians, and a complete embryology team all driven to be the best Reproductive Endocrinology practice in the southeast! We have won 3 consecutive national patient satisfaction awards and have pregnancy rates in the top 10% of the country. We pride ourselves in employee satisfaction! CFS is growing and has an immediate opening for a Medical Billing Specialist. This is a full-time position of approximately 40 hours per week and is based out of our North Charleston office (Ashley Phosphate). In this role duties will include: -Posting daily charges into practice's billing software. Charges must be entered within 3 days for non-cycle charges and within 6 days for cycle charges. -Daily balancing and processing of claims -Following up with insurance companies regarding claim submissions and payments -Answering patient questions regarding their billing statements -Transmitting electronic claims through the Clearinghouse -Collections -Accounts Receivable -General understanding of ICD-10 & CPT coding experience is required; working knowledge of Allscripts Practice Management software is preferred. CFS offers a competitive salary and full benefits including health and dental insurance, life insurance, disability insurance, a 401K retirement plan and annual bonuses based on the quality of patient care. The salary is commensurate with experience and qualifications. For more information about our practice please visit our website at www.coastalfertilityspecialists.com.