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)
SUMMARY:
Under general supervision of the Client Services Team Lead, the Medical Review Specialist assists paralegals and attorneys by reviewing and compiling medical and pharmacy records required for specific cases. The Medical Review Specialist will review medical and pharmacy records from facilities either directly or through a third party vendor, and enter their findings into the Case Management system accurately and in a timely manner. The Medical Review Specialist will use their organizational skills, attention to detail, and Case Management system knowledge to ensure all client- and case-related documentation is quickly available to the legal team to aid in their success. The Medical Review Specialist will summarize their findings and report the information to the Paralegal or Attorney.
MINIMUM REQUIREMENTS:
ESSENTIAL DUTIES AND RESPONSIBILITIES:
“Essential duties” are primarily job duties that incumbents must be able to perform unassisted or with some reasonable accommodation made by the employer.
WORKING HOURS:
Work may require more than 40 hours per week to perform the duties of the position.
WORKING CONDITIONS:
Work is performed in a normal heated or air-conditioned office environment.
The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of essential functions, responsibilities or requirements. This job description must not be misconstrued as a promise of employment, nor deemed as an employment contract.Motley Rice LLC is an Equal Opportunity Employer. We participate in e-verify.
Job Type: Full-time
Pay: $18.00 per hour
Benefits:
Schedule:
Work Location: In person
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