Medical Claims Review Manager jobs in Charleston, SC

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)

M
Medical Review Specialist
  • Motley Rice LLC
  • Mount Pleasant, SC FULL_TIME
  • 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:

    • High school diploma required; institutional degree in related field preferred
    • One (1) to four (4) years of progressive work experience in a law firm or comparable field preferred
    • Knowledge of medical terminology and/or medical field experience strongly preferred
    • Strong communication/interpersonal skills, with ability to follow-up without direction
    • Attention to detail & self -motivated
    • Ability to grasp concepts, perform internet research & overall competence in navigating programs
    • Must be deadline-driven, highly organized, and exude a positive professional demeanor with variety of people
    • Strong working knowledge of MS Word, Outlook, Excel

    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.

    • Clear communication skills
    • Review records and other documents for case relevancy
    • Ensure that intake information is properly documented in our case management system
    • Maintain/update our case management evidence database
    • Review and summarize the medical information to relay to the Paralegals or Attorneys
    • Works on special projects as needed

    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:

    • 401(k)
    • 401(k) matching
    • Dental insurance
    • Employee assistance program
    • Flexible spending account
    • Health insurance
    • Life insurance
    • Paid time off
    • Vision insurance

    Schedule:

    • Monday to Friday

    Work Location: In person

  • 16 Days Ago

K
Food & Beverage Manager
  • Kiawah Architectural Review Board
  • Johns Island, SC FULL_TIME
  • Kiawah Island Club's Cassique Clubhouse is now hiring a Food and Beverage Manager. Nestled between the 9th and 18th greens, our restaurants offer sweeping views of our private, nationally ranked links...
  • 9 Days Ago

H
Utilization Review Nurse/Case Manager
  • Health Partners Management Group
  • Charleston, SC FULL_TIME
  • SUMMARY: This position will actively and retrospectively review medical cases to confirm that patient receive appropriate care and ensures cost effectiveness of health care services. Utilization manag...
  • 12 Days Ago

K
Food & Beverage Manager
  • Kiawah Island Architectural Review Board
  • Johns Island, SC FULL_TIME
  • Kiawah Island Club's Cassique Clubhouse is now hiring a Food and Beverage Manager. Nestled between the 9th and 18th greens, our restaurants offer sweeping views of our private, nationally ranked links...
  • 7 Days Ago

K
Food & Beverage Manager - The River Course
  • Kiawah Island Architectural Review Board
  • Johns Island, SC FULL_TIME
  • On Kiawah Island, located just south of Charleston, South Carolina, day breaks across a pristine 10-mile beach, expansive marsh savannahs, ribboning rivers, and some of the most-acclaimed amenities av...
  • 7 Days Ago

L
Virtual Medical Office Manager
  • Lowcountry Medical Practice Management
  • Charleston, SC FULL_TIME
  • Virtual Medical Office Manager - Part Time 15 - 20 HOURS PER WEEK Virtual Medical Office Manager - Part Time/Remote 15 - 20 HOURS PER WEEK Attend to patients on the phone via text message and/or voice...
  • 1 Month Ago

Filters

Clear All

  • Filter Jobs by companies
  • More

0 Medical Claims Review Manager jobs found in Charleston, SC area

H
Remote Licensed Mental Health Counselor
  • Headway
  • Charleston, SC
  • Remote Licensed Mental Health Counselor (LMHC) Wage: Between $120-$131 an hour Are you a Licensed Mental Health Counselo...
  • 3/28/2024 12:00:00 AM

H
Remote Licensed Psychiatrist
  • Headway
  • Charleston, SC
  • Remote Licensed Psychiatrist Wage: Between $232 - $269 an hour Are you a licensed Psychiatrist looking to launch a priva...
  • 3/28/2024 12:00:00 AM

H
Remote Licensed Clinical Psychologist
  • Headway
  • Charleston, SC
  • Remote Licensed Clinical Psychologist Wage: Between $166-$196 an hour Are you a Licensed Clinical Psychologist looking t...
  • 3/28/2024 12:00:00 AM

H
Remote Licensed Marriage and Family Therapist
  • Headway
  • Charleston, SC
  • Remote Licensed Marriage and Family Therapist (LMFT) Wage: Between $120-$131 an hour Are you a Licensed Marriage and Fam...
  • 3/28/2024 12:00:00 AM

H
Remote Licensed Mental Health Therapist
  • Headway
  • Charleston, SC
  • Remote Licensed Mental Health Therapist (LMHT) Wage: Between $120-$131 an hour Are you a Licensed Mental Health Therapis...
  • 3/28/2024 12:00:00 AM

H
Remote Licensed Psychiatric Nurse Practioner
  • Headway
  • Charleston, SC
  • Remote Licensed Psychiatric Nurse Practitioner Wage: Between $203 - $269 an hour Are you a licensed Psychiatric Nurse lo...
  • 3/28/2024 12:00:00 AM

V
Psychiatrist
  • VitalCore Health Strategies
  • North Charleston, SC
  • Job Description Job Description Join the VitalCore Health Strategies Team! Apply today, and help us to make a difference...
  • 3/27/2024 12:00:00 AM

L
Clinical Testing Psychologist (PhD, PsyD)
  • LifeStance Health
  • North Charleston, SC
  • At LifeStance Health, we believe in a truly healthy society where mental and physical healthcare are unified to make liv...
  • 3/25/2024 12:00:00 AM

Charleston is the oldest and largest city in the U.S. state of South Carolina, the county seat of Charleston County, and the principal city in the Charleston–North Charleston–Summerville Metropolitan Statistical Area. The city lies just south of the geographical midpoint of South Carolina's coastline and is located on Charleston Harbor, an inlet of the Atlantic Ocean formed by the confluence of the Ashley, Cooper, and Wando rivers. Charleston had an estimated population of 134,875 in 2017. The estimated population of the Charleston metropolitan area, comprising Berkeley, Charleston, and Dorche...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$92,450 to $117,875
Charleston, South Carolina area prices
were up 1.5% 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