Medical Claims Review Manager jobs in Casper, WY

Medical Claims Review Manager oversees the performance, productivity, and quality of the medical claims review staff. Responsible for hiring, training, and firing medical claims review staff. Being a Medical Claims Review Manager evaluates medical claims review processes and recommends process improvements. Serves as a technical resource for all medical review workers. Additionally, Medical Claims Review Manager typically requires an RN or BSN. Requires a bachelor's degree. Typically reports to a head of a unit/department. The Medical Claims Review Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Medical Claims Review Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)

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UTILIZATION REVIEW COORDINATOR
  • Wyoming Behavioral Institute
  • Casper, WY FULL_TIME
  • Responsibilities:
    Consider a career with meaning and purpose!

    Join Wyoming Behavioral Institute as a Utilization Review Coordinator, and enjoy a career that provides purpose, meaning and career development opportunities.
    Wyoming Behavioral Institute, located in Casper, WY is a psychiatric hospital providing excellent care to children, adolescent and adults. We take pride in being a cohesive, family-friendly, flexible, educational and welcoming work environment!

    Hourly rates: $25 - $35 per hour
    Shift- Days: M-F 8am to 5pm, FT (32 – 40 hours)

    Your Benefits will include:
    • Paid training program
    • Excellent and affordable full benefits package (including employee wellness) within 30 days of starting
    • Start earning Paid Time off from your first day of work
    • Education/Tuition Reimbursement program – continue to develop your skills
    • Serve others in a therapeutic, teamwork-oriented work environment with a diverse and collaborative multi-disciplinary team of clinical professionals
    • Opportunities to grow and develop your clinical skills in Case Management and Utilization Review
    Your role and responsibilities:
    • YOU WILL use your clinical skills to work with the Utilization Review & Treatment teams to assist with patient caseloads, pre-certifications, assist with performing concurrent reviews & certify cases for inpatient and residential clients.

    • YOU WILL
      be an active interdisciplinary team member with the treatment team, physicians, Therapists, Case Management and other disciplines and will interface with payer sources and insurance companies to support & optimize patient treatment.


    • YOU WILL be equipped to communicate effectively the necessary information regarding patient status, treatment, covered services, treatment plans, transition plans, discharge and upcoming reviews. Work actively with clinicians, insurance plans, business associates and outside agencies & treatment providers to achieve the best outcome for WBI patients.

    .

    Your Qualifications include:
    • You Must be at twenty-one (21) years of age to apply

    • You must have a BSW or BA/BS in social sciences, healthcare, or related human services degree

    • You must be in good mental health and physical condition (able to walk, bend, reach), and willing to work with psychiatric patients, families, providers and insurance companies in an active & busy treatment setting.
    .
    • You must have effective interpersonal and presentation skills when working with treatment teams, physicians, patients and staff members
    .
    • You must have one year of experience in social services, clinical services, public health, community resource development or related discipline.

    • You will use your expertise as a member of the treatment team and will be expected to give input into treatment decisions, consistent with your education and clinical experience.


    Qualifications:
    Your Qualifications include:
    • You Must be at twenty-one (21) years of age to apply

    • You must have a BSW or BA/BS in social sciences, healthcare, or related human services degree

    • You must be in good mental health and physical condition (able to walk, bend, reach), and willing to work with psychiatric patients, families, providers and insurance companies in an active & busy treatment setting.
    .
    • You must have effective interpersonal and presentation skills when working with treatment teams, physicians, patients and staff members
    .
    • You must have one year of experience in social services, clinical services, public health, community resource development or related discipline.

    • You will use your expertise as a member of the treatment team and will be expected to give input into treatment decisions, consistent with your education and clinical experience.

  • 10 Days Ago

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Paid Product Tester
  • Product Review Jobs
  • Arvada, WY FULL_TIME
  • Compensation: Varies per assignment. Up to $500 per week.Location: Remote (USA)Company: ProductReviewJobsThank you for your interest in becoming a Paid Product Tester. This opportunity is for completi...
  • 1 Day Ago

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Paid Product Tester
  • Product Review Jobs
  • Recluse, WY FULL_TIME
  • Compensation: Varies per assignment. Up to $500 per week.Location: Remote (USA)Company: ProductReviewJobsThank you for your interest in becoming a Paid Product Tester. This opportunity is for completi...
  • 2 Days Ago

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Paid Product Tester
  • Product Review Jobs
  • Kinnear, WY FULL_TIME
  • Compensation: Varies per assignment. Up to $500 per week.Location: Remote (USA)Company: ProductReviewJobsThank you for your interest in becoming a Paid Product Tester. This opportunity is for completi...
  • 2 Days Ago

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Paid Product Tester
  • Product Review Jobs
  • Fort Washakie, WY FULL_TIME
  • Compensation: Varies per assignment. Up to $500 per week.Location: Remote (USA)Company: ProductReviewJobsThank you for your interest in becoming a Paid Product Tester. This opportunity is for completi...
  • 2 Days Ago

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Paid Product Tester
  • Product Review Jobs
  • LINCH, WY FULL_TIME
  • Compensation: Varies per assignment. Up to $500 per week.Location: Remote (USA)Company: ProductReviewJobsThank you for your interest in becoming a Paid Product Tester. This opportunity is for completi...
  • 28 Days Ago

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0 Medical Claims Review Manager jobs found in Casper, WY area

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Dishwasher
  • Olive Garden
  • Casper, WY
  • For this position, pay will be variable by location-See additional job details and benefits below. Our Winning Family St...
  • 4/26/2024 12:00:00 AM

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Accounting Clerk
  • Adecco Staffing, USA
  • Casper, WY
  • Job Title: Accounting Specialists - Temporary to Hire, Temporary or Direct Hire Opportunities Location: Casper, WY Compa...
  • 4/26/2024 12:00:00 AM

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Delivery Driver-CDL
  • Pioneer Materials West Inc
  • Casper, WY
  • ** Delivery Driver-CDL** **Job Category****:** Operations **Requisition Number****:** DELIV007282 Showing 1 location **J...
  • 4/25/2024 12:00:00 AM

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Manufacturing Associate
  • Manpower USA
  • Casper, WY
  • Our client, in Casper, WY is seeking several Assemblers to join their team. As an Assembler, you will be part of the Man...
  • 4/24/2024 12:00:00 AM

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Field Application Specialist - HammerHead
  • The Toro Company
  • Casper, WY
  • Typical Starting Pay: $80,000-$105,000, plus bonuses. What Can We Give You? Medical, Dental, Vision, 401K Matching up to...
  • 4/23/2024 12:00:00 AM

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Manufacturing Associate
  • Manpower
  • Casper, WY
  • Our client, in Casper WY is seeking a Manufacturing Associate to join their team. As a manufacturer you will be part of ...
  • 4/23/2024 12:00:00 AM

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Server
  • Outback Steakhouse
  • Evansville, WY
  • Do you like hosting the party? Come join the Evergreen Restaurant Group/Italian Restaurant Group, a franchisee of Outbac...
  • 4/23/2024 12:00:00 AM

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Receptionist PRN at Elkhorn Valley Rehabilitation Hospital
  • Ernest Health
  • Casper, WY
  • Overview: At Elkhorn Valley Rehabilitation Hospital, our hospital has been ranked in the Top 10% nationally for rehabili...
  • 4/22/2024 12:00:00 AM

Casper is a city in and the county seat of Natrona County, Wyoming, United States. Casper is the second largest city in the state, according to the 2010 census, with a population of 55,316. Only Cheyenne, the state capital, is larger. Casper is nicknamed "The Oil City" and has a long history of oil boomtown and cowboy culture, dating back to the development of the nearby Salt Creek Oil Field. In 2010, Casper was named the highest-ranked family-friendly small city in the West, and ranked eighth overall in the nation in Forbes magazine's list of "the best small cities to raise a family". Casper ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$93,571 to $119,305
Casper, Wyoming area prices
were up 2.9% from a year ago

Medical Claims Review Manager in Paramus, NJ
Support management with leading Medical Review team to ensure all types of claims requiring medical reviews are completed in compliance with State, Federal, accreditation standards and other applicable regulations.
February 01, 2020
Medical Claims Review Manager in Nashua, NH
By truly combining claims and bill review, the two systems are kept in sync utilizing the scheduled jobs of the aforementioned standard model; however, for real-time data updates, claims examiners are granted access to the entire live bill review system.
January 13, 2020
Medical Claims Review Manager in Davenport, IA
Complex claim errors can only be caught by physician reviewers with the clinical experience to spot mistakes that automated systems can’t detect.
January 03, 2020