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)
```Duties:```
- Oversee the daily operations of the medical office, ensuring smooth and efficient workflow
- Manage and supervise office staff, including hiring, training, and performance evaluations
- Develop and implement office policies and procedures to maintain compliance with industry regulations
- Coordinate patient scheduling and ensure timely and accurate billing
- Collaborate with healthcare providers to optimize patient care and improve patient outcomes
- Utilize electronic health record systems such sas eClinicalWorks or Epic for documentation and data management
- Monitor managed care contracts and utilization management to maximize reimbursement
```Qualifications:```
- Bachelor's degree in healthcare administration or related field (preferred)
- Previous experience in medical office management or a similar role
- Knowledge of veterinary or critical care hospital operations (preferred)
- Proficiency in electronic health record systems such as eClinicalWorks or Epic
- Strong leadership skills with the ability to effectively manage a team
- Excellent communication and interpersonal skills
- Detail-oriented with strong organizational abilities
Please note that this job description is intended to provide a general overview of the position. Duties, responsibilities, and qualifications may be subject to change based on the specific needs of the medical office.
Job Type: Full-time
Pay: $20.36 - $24.52 per hour
Benefits:
Schedule:
Experience:
Work Location: In person
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