Medical Claims Review Manager jobs in Milwaukee, WI

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)

W
Claims Manager
  • West Bend Insurance Company
  • West, WI FULL_TIME
  • Company Overview

    Recognized as a Milwaukee Journal Sentinel Top Workplace for 12 consecutive years, including three years of being honored as number one! Join us at West Bend, where we believe that our associates are our greatest asset. We hire talented individuals who are conscientious, dedicated, customer focused, and able to build lasting relationships. We create and maintain an environment where you feel a sense of belonging and appreciation. Your diversity of thought, experience, and knowledge are valued. We’re committed to fostering a welcoming culture, offering you opportunities for meaningful work and professional growth. More than a workplace, we celebrate our successes and take pride in serving our communities.

    Responsibilities & Qualifications

    Summary of Responsibilities

     

    Manage a team of senior level claim specialists and/or supporting technical staff. Claims processed are primarily third party claims on our personal lines and commercial lines of business but could include all lines of business.  Oversee the investigation and settlement of all claims, litigated and non-litigated assigned to the team. Provide advice and direction to claim representatives. Responsible for the selection, training, development and performance of personnel as well as performance reviews, salary adjustments and promotions. Handle special projects as assigned.

     

    Preferred Experience and Skills

    • 3- 5 years of prior supervision of claims personnel
    • 7 years of claims handling experience with at least 3 years of litigated file handling
    • Ability to lead, mentor and develop personnel.
    • Interpersonal skills
    • Oral and written communicational skills
    • Proficient in Word and Excel

     

    Preferred Education and Training

    • Bachelor’s degree in Business, Insurance or related field
    • Continuing insurance education
    • Insurance Designations: AIC, AIM, CPCU, SCLA

     

    #LI-BW1

     

    EEO

    West Bend provides equal employment opportunities to all associates and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, and promotion.

  • 11 Days Ago

R
Medical Insurance Claims Specialist
  • Robert Half
  • Greendale, WI PER_DIEM
  • Robert Half is seeking a detail-oriented and highly organized individual to join our client's team as a Medical Insurance Claims Follow Up Specialist. In this role, you will be responsible for ensurin...
  • 6 Days Ago

M
Claims Manager - Risk Management
  • Milwaukee County Transit System
  • Milwaukee, WI FULL_TIME
  • JOB SUMMARY: Manage worker’s compensation, return-to-work and general liability claim programs for MCTS. Serve as liaison between MCTS and third-party administrators to ensure accurate, timely and eff...
  • 18 Days Ago

W
Claims Analytics Manager
  • West Bend Insurance Company
  • West, WI FULL_TIME
  • Company Overview Recognized as a Milwaukee Journal Sentinel Top Workplace for 12 consecutive years, including three years of being honored as number one! Join us at West Bend, where we believe that ou...
  • 3 Days Ago

C
WI - 1099 Property Adjuster
  • Copper Claims Services, Inc.
  • Milwaukee, WI FULL_TIME
  • 1099 Property Claims Adjuster Copper Claims Services is a quickly growing independent loss adjusting firm based out of Irvine, CA with offices in California, Arizona, Oregon, Nevada, Washington, Utah,...
  • 14 Days Ago

M
Accounting Manager - MCWAH (Graduate Medical Education)
  • Medical College of Wisconsin
  • Milwaukee, WI FULL_TIME
  • Position Description: Every great life-changing discovery begins the same way-with new knowledge. It can change everything, from a single life to the future of entire communities. That's why academic ...
  • 1 Month Ago

Filters

Clear All

Filter Jobs By Location
  • Filter Jobs by companies
  • More

0 Medical Claims Review Manager jobs found in Milwaukee, WI area

H
Remote Licensed Clinical Psychologist
  • Headway
  • Milwaukee, WI
  • Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
  • 4/24/2024 12:00:00 AM

H
Remote Licensed Marriage and Family Therapist
  • Headway
  • Milwaukee, WI
  • Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
  • 4/20/2024 12:00:00 AM

H
Remote Licensed Mental Health Counselor
  • Headway
  • Milwaukee, WI
  • Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
  • 4/20/2024 12:00:00 AM

H
Remote Licensed Clinical Social Worker
  • Headway
  • Milwaukee, WI
  • Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
  • 4/20/2024 12:00:00 AM

H
Remote Licensed Professional Counselor
  • Headway
  • Milwaukee, WI
  • Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
  • 4/20/2024 12:00:00 AM

H
Remote Licensed Psychiatric Nurse Practitioner
  • Headway
  • Milwaukee, WI
  • Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
  • 4/20/2024 12:00:00 AM

L
Personal Services Assistant
  • Life Space Communities
  • Milwaukee, WI
  • Community: Newcastle Place Address: 12600 N Port Mequon, Wisconsin 53092 Pay Range $15. 00-$19. 83+ Hourly Live your pur...
  • 4/11/2024 12:00:00 AM

L
Personal Services Assistant
  • Life Space Communities
  • Milwaukee, WI
  • Community: Newcastle Place Address: 12600 N Port Mequon, Wisconsin 53092 Pay Range $15. 00-$19. 83+ Hourly Live your pur...
  • 4/11/2024 12:00:00 AM

Milwaukee lies along the shores and bluffs of Lake Michigan at the confluence of three rivers: the Menomonee, the Kinnickinnic, and the Milwaukee. Smaller rivers, such as the Root River and Lincoln Creek, also flow through the city. Milwaukee's terrain is sculpted by the glacier path and includes steep bluffs along Lake Michigan that begin about a mile (1.6 km) north of downtown. In addition, 30 miles (48 km) southwest of Milwaukee is the Kettle Moraine and lake country that provides an industrial landscape combined with inland lakes. According to the United States Census Bureau, the city has ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$96,986 to $123,659
Milwaukee, Wisconsin area prices
were up 1.8% 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