Medical Policy Specialist jobs in Delaware

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 Insurance Specialist
  • Medical Associates of Delaware
  • Wilmington, DE PART_TIME
  • A medical practice in Wilmington, DE is looking for a part-time medical insurance verification specialist to assist with insurance verification, pre-certifications, referrals, and patient scheduling, etc.

    We look forward to hearing from you soon and adding great new members to our team!

    Responsibilities:

    • Verify benefit eligibility
    • Initiate and obtain prior authorization from insurance carriers
    • Select the appropriate insurance and entering all necessary billing information
    • Establish and maintain effective relationships with patients
    • Follow up with department email and authorization faxes
    • Ensure the accuracy of data
    • Obtain missing information from patients and practices
    • Answer patient coverage questions

    Qualifications:

    • High school diploma or equivalent required
    • Knowledge of benefits verification and authorizations
    • Computer skills including proficiency in Windows MS Office – Excel, Word and Outlook
    • Customer service skills with excellent verbal and written communication skills
    • Detail oriented, following through on tasks, problem-solving, troubleshooting and multi-tasking
    • Being a team player and having professionalism in the workplace

    Job Type: Part-time

    Pay: $15.00 - $17.00 per hour

    Expected hours: 25 per week

    Weekly day range:

    • Monday to Friday

    Ability to Relocate:

    • Wilmington, DE: Relocate before starting work (Required)

    Work Location: In person

  • 1 Month Ago

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Management Analyst
  • US Office of Field Policy and Management
  • Wilmington, DE FULL_TIME
  • Duties The following are the duties of this position at the GS-9. If you are selected at a lower grade level, you will have the opportunity to learn to perform all these duties, and will receive train...
  • 2 Months Ago

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Senior Financial Analyst, CVRM
  • 10001188 - Accountancy Specialist
  • Wilmington, DE FULL_TIME
  • As the Senior Financial Analyst for CVRM, you will support therapeutic area Sales, Marketing and Medical teams by providing financial guidance and insights. This role offers the opportunity to build r...
  • 16 Days Ago

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Ophthalmic Technician
  • Omni Eye Specialist Pa
  • Wilmington, DE FULL_TIME
  • ** Regular travel to satellite locations is required ** ESSENTIAL JOB DUTIES: Greets patients and visitors in a prompt, courteous and helpful manner. Obtains patient history and transcribes results in...
  • 18 Days Ago

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Policy Manager
  • Biden for President
  • Wilmington, DE FULL_TIME
  • The policy advisor would support the deputy policy directors to contrast President Biden and Vice President Harris’s policy accomplishments and agenda with the Trump's, including in key states and dem...
  • 2 Months Ago

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Policy Associate
  • Biden for President
  • Wilmington, DE FULL_TIME
  • The Policy Associate will work with the National Policy Director and the Biden for President Policy Team by providing administrative support, project-managing work streams, assisting with material dra...
  • 2 Months Ago

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(Physician) Medical Specialist 2
  • Office for People with Developmental Disabilities
  • Thiells, NY
  • Job Description Job Description EMPLOYMENT OPPORTUNITY ANNOUNCEMENT EOA #: 23-061RR EOA DATE: March 15, 2024 REPLY BY: S...
  • 6/11/2024 12:00:00 AM

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Medical Specialist
  • U.S. Air Force Reserve
  • Position Summary Our hundreds of medical facilities around the world are only as good as the staff who run them. Providi...
  • 6/10/2024 12:00:00 AM

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Bio Medical Specialist
  • United Health Services
  • Johnson City, NY
  • Bio Medical Specialist, UHS Wilson Medical Center United Health Services is seeking a Bio Medical Specialist to join our...
  • 6/10/2024 12:00:00 AM

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Medical Specialist 2
  • State of New York
  • Tupper Lake, NY
  • Please note: State agencies that contact job applicants do not usually request personal or financial information via tex...
  • 6/9/2024 12:00:00 AM

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Medical Specialist 1
  • State of New York
  • Tupper Lake, NY
  • Please note: State agencies that contact job applicants do not usually request personal or financial information via tex...
  • 6/9/2024 12:00:00 AM

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Medical Specialist 2
  • State of New York
  • Thiells, NY
  • Please note: State agencies that contact job applicants do not usually request personal or financial information via tex...
  • 6/9/2024 12:00:00 AM

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Medical Assistant/ Medication Specialist
  • Nidraveda PA
  • San Antonio, TX
  • Job Description Job Description We are looking for someone with a professional attitude, a dedication to healthcare, and...
  • 6/9/2024 12:00:00 AM

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Certified Medication Specialist
  • Mosaic
  • Beatrice, NE
  • Schedule: Full-Time Days, Evenings, Overnights Part-Time Evenings If making a positive impact in the lives of others is ...
  • 6/8/2024 12:00:00 AM

Delaware is 96 miles (154 km) long and ranges from 9 miles (14 km) to 35 miles (56 km) across, totaling 1,954 square miles (5,060 km2), making it the second-smallest state in the United States after Rhode Island. Delaware is bounded to the north by Pennsylvania; to the east by the Delaware River, Delaware Bay, New Jersey and the Atlantic Ocean; and to the west and south by Maryland. Small portions of Delaware are also situated on the eastern side of the Delaware River sharing land boundaries with New Jersey. The state of Delaware, together with the Eastern Shore counties of Maryland and two co...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$91,210 to $111,330

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