Medical Claims Review Manager jobs in Providence, RI

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)

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RI - 1099 Property Claims Adjuster
  • Copper Claims Services, Inc.
  • Providence, RI FULL_TIME
  • 1099 Property Claims Adjuster

    Copper Claims Services is a quickly growing independent loss adjusting firm based out of Irvine, CA.

    Copper Claims Services excels in providing custom claims solutions for Property and Casualty, Transportation and High Net Worth, with an emphasis on Specialized Programs.

    We are currently looking for licensed adjusters (or individuals who will obtain their license upon onboarding) to assist with daily claims handling for the Rhode Island area. In this role, you will manage, investigate and resolve homeowner and commercial property losses of moderate to severe complexity with minimal supervision to include completing field investigations, evaluating and analyzing coverage, completing property damage estimates, reporting findings to various clients, and handling files to the conclusion of the claim.

    In this role, you will:

    • Handle claims during local catastrophes
    • Complete field investigations including inspections, interviews, preparing diagrams, taking photographs, and various other tasks
    • Analyze insurance coverage issues on specific claims and make appropriate recommendations to our clients
    • Prepare detailed estimates in Xactimate based on our client’s specifications and parameters
    • Prepare clear, concise, and timely narrative reports for our clients
    • Create ITV reports
    • Evaluate co-insurance calculations and penalties if applicable
    • Maintain continuous and professional communication with our clients to ensure their needs are being met.
    • Analyze and evaluate damages including reserves, property estimates, business personal property inventories, business interruption, and business income losses
    • Investigate, analyze, adjust and negotiate settlements with insured’s in compliance with our client’s direction
    • Coordinate and oversee vendors such as emergency service contractors, origin and cause investigators, general contractors, engineers, etc.

    Qualifications:

    • 5 years of field Property adjusting experience
    • Ability to climb ladders/Access roofs
    • Thorough knowledge and understanding of roofing, HVAC, and various other mechanical specialties
    • Knowledge of Commercial Lines insurance policies
    • Proficient in Xactimate including Sketch
    • Previous experience with Xactanalysis preferred
    • Proficient in Microsoft Office (Word, Excel, and Outlook)
    • Effective negotiation skills
    • Ability to effectively and independently manage workload
    • Proven ability to provide exceptional customer service
    • Strong written and verbal communication skills
    • Exceptional organization and time management skills

    Job Type: Full-time

    Pay: $30.00 - $35.00 per hour

    Schedule:

    • 8 hour shift
    • Monday to Friday

    Work setting:

    • Outdoor work

    Work Location: On the road

  • 28 Days Ago

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Paid Product Tester
  • Product Review Jobs
  • Prudence Island, RI FULL_TIME
  • Compensation: Varies per assignment. Up to $500 per week.Location: Remote (USA)Company: ProductReviewJobsThank you for your interest in becoming a Paid Product Tester. This opportunity is for completi...
  • 1 Day Ago

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Claims Appraiser
  • State Farm Mutual Automobile Insurance Company
  • Woonsocket, RI FULL_TIME
  • Claims Appraiser - Auto Estimatics US-RI-Providence Job ID: 2024-36297 Type: Regular Full Time # of Openings: 1 Category: Claims and Investigation Providence, RI Overview Build your career at one of t...
  • 11 Days Ago

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Attorney/Lawyer - Doc Review (On-Site)
  • Robert Half
  • New York, NY OTHER
  • **LOCATED IN MIDTOWN, MANHATTAN** Our client, a mid-sized Commercial Litigation Law Firm, is seeking a group of attorneys to assist in a large-scale document review project. Candidates would need to c...
  • 21 Days Ago

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Permanent Utilization Review Registered Nurse
  • Aya Healthcare
  • Attleboro, MA FULL_TIME
  • Aya Healthcare has an immediate opening for the following position: Utilization Review Registered Nurse in Attleboro, Massachusetts. This is a 13 week contract position that requires at least one year...
  • 28 Days Ago

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Medical Billing Manager
  • Confidential
  • Cranston, RI FULL_TIME
  • Job Summary: We are seeking an experienced Medical Billing Manager to lead our billing team in the healthcare industry. The Medical Billing Manager will be responsible for overseeing all aspects of th...
  • Just Posted

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0 Medical Claims Review Manager jobs found in Providence, RI area

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Remote Licensed Mental Health Counselor
  • Headway
  • Providence, RI
  • Remote Licensed Mental Health Counselor (LMHC) Wage: Between $95-$120 an hour Are you a Licensed Mental Health Counselor...
  • 4/26/2024 12:00:00 AM

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Remote Licensed Marriage and Family Therapist
  • Headway
  • Providence, RI
  • Remote Licensed Marriage and Family Therapist (LMFT) Wage: Between $95-$120 an hour Are you a Licensed Marriage and Fami...
  • 4/26/2024 12:00:00 AM

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Head of Medical Writing
  • Aerovate Therapeutics Inc.
  • Waltham, MA
  • Aerovate (AVTE) is a clinical stage biopharmaceutical company focused on developing drugs that meaningfully improve the ...
  • 4/26/2024 12:00:00 AM

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Remote Licensed Professional Counselor
  • Headway
  • Providence, RI
  • Remote Licensed Professional Counselor (LPC) Wage: Between $95-$120 an hour Are you a Licensed Professional Counselor lo...
  • 4/26/2024 12:00:00 AM

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Remote Licensed Clinical Social Worker
  • Headway
  • Providence, RI
  • Remote Licensed Clinical Social Worker (LCSW) Wage: Between $95-$120 an hour Are you a Licensed Clinical Social Worker l...
  • 4/26/2024 12:00:00 AM

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Remote Licensed Clinical Psychologist
  • Headway
  • Providence, RI
  • Remote Licensed Clinical Psychologist Wage: Between $95-$174 an hour Are you a Licensed Clinical Psychologist looking to...
  • 4/26/2024 12:00:00 AM

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Psychiatrist Outpatient Only
  • LifeStance Health
  • Providence, RI
  • At LifeStance Health, we believe in a truly healthy society where mental and physical healthcare are unified to make liv...
  • 4/22/2024 12:00:00 AM

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Nurse Practitioner-Psychiatry Outpatient Only
  • LifeStance Health
  • Providence, RI
  • At LifeStance Health, we believe in a truly healthy society where mental and physical healthcare are unified to make liv...
  • 4/22/2024 12:00:00 AM

The Providence city limits enclose a small geographical region with a total area of 20.5 square miles (53 km2); 18.5 square miles (48 km2) of it is land and the remaining 2.1 square miles (5.4 km2) is water (roughly 10%). Providence is located at the head of Narragansett Bay, with the Providence River running into the bay through the center of the city, formed by the confluence of the Moshassuck and Woonasquatucket Rivers. The Waterplace Park amphitheater and riverwalks line the river's banks through downtown. Providence is one of many cities claimed to be founded on seven hills like Rome. The...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$102,353 to $130,501
Providence, Rhode Island area prices
were up 1.6% 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