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)
About us
High Rock Internal Medicine, PA is a busy internal medicine practice in Lexington, NC. We are a professional office that seeks to give the best care to our patients.
```Duties:```
- Oversee the day-to-day operations of the medical practice, ensuring smooth and efficient workflow and coverage
- Manage and supervise staff, including hiring, training, and annual reviews
-Implement policies and procedures to improve operational efficiency
- Coordinate with healthcare providers to ensure quality patient care
-Experience in Quality Metrics and working with ACOs to meet all targets
- Collaborate with human resources to handle employee relations and compliance matters
- Implement and maintain electronic health record systems to streamline medical management processes
- Ensure compliance with regulatory requirements and managed care contracts
- Provide critical care support in emergency situations
```Qualifications:```
- Proven experience in medical practice management or healthcare administration
- Strong knowledge of Internal Medicine operations and medical administrative support functions
- Excellenct customer service skills
- Familiarity with electronic health record systems
- Excellent leadership and communication skills
- Ability to manage multiple priorities and work effectively under pressure
Note: This job description is intended to provide a general overview of the position. Duties and responsibilities may be subject to change based on organizational needs.
Please submit your resume highlighting relevant experience for consideration.
Job Type: Full-time
Pay: $47,000.00 - $53,000.00 per year
Benefits:
Healthcare setting:
Schedule:
Experience:
Work Location: In person
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