Medical Claims Review Manager jobs in Salisbury, NC

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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Corporate Director of Medical Review
  • Gentiva
  • Mooresville, NC FULL_TIME
  • Our Company

     

    Gentiva is an industry leader in hospice, palliative, home health, and personal home care. Our place is by the side of those who need us, offering physical, spiritual and emotional support to patients and their families so they may make the most of every moment. We believe that better care for caregivers and clinicians means better care for everyone, so we offer ongoing professional training, lower nurse-to-patient ratios, and comprehensive benefits for eligible employees. Here, you’ll join gifted colleagues who make a lasting difference in people’s lives every day.

     

     

     

     

     

     

     

     

     

     

     

     

    Overview

    We’re looking for a Corporate Director of Medical Review to join our team. You will report directly to the Corporate Director of Medical Review Lead. You will be responsible for responding to external and internal Payor audit requests and communicating findings to Leadership, thereby assisting with, and improving Clinical and Regulatory Compliance for the company.

    About You

    • Associates or Bachelor degree preferred
    • Registered nurse license preferred but not required
    • Three years of Hospice and Home Care experience with one year supervisory or management experience

    We Offer

    • Comprehensive Benefits Package: Health Insurance, 401k Plan, Tuition Reimbursement, PTO
    • Competitive Salaries
    • Mileage Reimbursement
    • Professional Growth and Development Opportunities

    Legalese

    • This is a safety-sensitive position
    • Employee must meet minimum requirements to be eligible for benefits
    • Where applicable, employee must meet state specific requirements
    • We are proud to be an EEO employer
    • We maintain a drug-free workplace

    Location

    Gentiva
  • 2 Months Ago

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Clinical Review Specialist
  • Gentiva
  • Mooresville, NC FULL_TIME
  • Our Company Gentiva is an industry leader in hospice, palliative, home health, and personal home care. Our place is by the side of those who need us, offering physical, spiritual and emotional support...
  • 5 Days Ago

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Clinical Review Specialist - Remote
  • Gentiva
  • Mooresville, NC FULL_TIME
  • Our Company Gentiva is an industry leader in hospice, palliative, home health, and personal home care. Our place is by the side of those who need us, offering physical, spiritual and emotional support...
  • 1 Month Ago

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Review Specialist Office Operations
  • Gentiva Hospice
  • Mooresville, NC FULL_TIME
  • Our Company Gentiva is an industry leader in hospice, palliative, home health, and personal home care. Our place is by the side of those who need us, offering physical, spiritual and emotional support...
  • 2 Months Ago

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Unit Manager - Behavioral Health, FT
  • Davis Regional Medical Center
  • STATESVILLE, NC FULL_TIME
  • Plans, manages and coordinates therapeutic program services and ensures compliance with philosophy, policies and procedures of Davis Regional Medical Center. Ensures delivery of services by multidisci...
  • 1 Month Ago

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Senior Claims Examiner
  • Lowes
  • Mooresville, NC FULL_TIME
  • Expand your career possibilities.Thank you for dedicating your time and talent to Lowe’s. We want to give you more opportunities to learn and grow, so if you find a position you’re interested in below...
  • 11 Days Ago

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0 Medical Claims Review Manager jobs found in Salisbury, NC area

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Resident Care Coordinator
  • Brookdale Senior Living
  • Salisbury, NC
  • Overview Voted by Newsweek in 2024 as one of America's Greatest Workplaces for Diversity Early Access to Paycheck with E...
  • 3/19/2024 12:00:00 AM

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Remote Licensed Clinical Social Worker
  • Headway
  • Concord, NC
  • Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
  • 3/19/2024 12:00:00 AM

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Remote Licensed Mental Health Therapist
  • Headway
  • Huntersville, NC
  • Mental health clinicians use Headway in a number of ways, ranging from conducting psychotherapy sessions with patients t...
  • 3/19/2024 12:00:00 AM

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Retail Loss Prevention Customer Service Associate - Salisbury
  • The TJX Companies, Inc.
  • Salisbury, NC
  • All 1,000 of our Marshalls stores embrace discovery, from designer luggage to statement shoes. Our assortment of brands ...
  • 3/19/2024 12:00:00 AM

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1st Shift Warehouse Worker
  • Aldi
  • Salisbury, NC
  • Position Type: Full-Time Average Hours: 30-35 hours per week Starting Wage: Up to $26.00 per hour (based on shift and sc...
  • 3/19/2024 12:00:00 AM

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1st Shift Warehouse Stocker
  • Aldi
  • Salisbury, NC
  • Position Type: Full-Time Average Hours: 30-35 hours per week Starting Wage: Up to $26.00 per hour (based on shift and sc...
  • 3/19/2024 12:00:00 AM

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Adult and Child Psychiatrist - Outpatient - Hybrid Schedule
  • LifeStance Health
  • Concord, NC
  • At LifeStance Health, we believe in a truly healthy society where mental and physical healthcare are unified to make liv...
  • 3/17/2024 12:00:00 AM

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Medical Office Assistant
  • PEACEFUL AURA BEHAVIORAL HEALTH SERV
  • Charlotte, NC
  • Job Description Job Description We are looking for an Office Assistant (MA or CNA preferred) flexible to work both as a ...
  • 3/15/2024 12:00:00 AM

Salisbury (/ˈsɔːlzbəri/ SAWLZ-bər-ee) is a city in the Piedmont of North Carolina; it is the county seat of Rowan County. Located 44 miles northeast of Charlotte and within its metropolitan area, the town has attracted a growing population. This was 33,663 in the 2010 Census (growing 27.8% from the Census in 2000). Founded in 1753, Salisbury is noted for its historic preservation, with five Local Historic Districts and ten National Register Historic Districts. Salisbury is the home to North Carolina soft drink, Cheerwine, regional supermarket, Food Lion and Rack Room Shoes. It is one of two ci...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$92,387 to $117,795
Salisbury, North Carolina area prices
were up 1.5% 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