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)
Functioning within the Health System’s mission, values, objectives, and policies and procedures, the Medical Staff Peer Review Assistant is responsible for coordination of medical staff peer review committee functions including, but not limited to, compilation of statistics, agenda preparation, assignment of cases for physician review, preparation of meeting packet, take/type meeting minutes, referral letters and any meeting follow-up tasks. In addition, this position serves as department secretary for the Quality Resource Management Department.
Education: High School diploma or equivalent (GED) required. An associate’s degree in business/secretarial/administrative support is preferred.
Licensure/Certification: N/A
Experience: Minimum of one (1) year of experience in the clinical or healthcare business setting preferred. Experience with Word, Excel, and Outlook is preferred.
Skills: Excellent written and oral communication, listening and interpersonal skills, and basic competency with
Microsoft products (i.e. Word and Excel) preferred. Must also have the demonstrated ability to work
Independently and the ability to juggle competing demands and deal with interruptions.
0 Medical Claims Review Manager jobs found in Lima, OH area