Medical Claims Review Manager jobs in Santa Barbara, CA

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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Claims Examiner
  • CenCal Health
  • Santa Barbara, CA FULL_TIME
    • Review, price and release claims associated with the assigned claim types (paper and electronic)
    • Review Manual Review reports that suspend for review on all CenCal Health programs
    • Review audit reports for all CenCal Health programs
    • Analyze current processes and work with Supervisor to automate or improve quality where fit
    • Assist with ideas for creation of SCF (System Change Forms) when applicable
    • Keep up to date on all CenCal Health policies and provide materials for improvement projects within Department
    • Assure all regulatory guidelines are being followed and monitored
    • Maintain daily activity log
    • Assist with the processing of claims
    • Audit and report all billing & error trends found during the course of review and data entry;
    • Maintain processes and timelines required by AB1455 Claims Settlement Practices and DHCS Regulations

    Other duties and projects as assigned

  • 11 Days Ago

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Medical Billing Manager
  • The Spine and Orthopedic Center
  • Santa Barbara, CA FULL_TIME
  • Seeking an experienced Lead Medical Biller. Must have a minimum of 5 years of experience with ICD-10, CPT and HCPCS coding systems, as well as E&M Guidelines. Knowledge of health insurance benefits, b...
  • 9 Days Ago

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Territory Manager - Santa Barbara
  • Zoll Medical Corporation
  • Santa Barbara, CA FULL_TIME
  • Territory Manager - Santa Barbara Location: Remote, CA, United States of America Cardiac Management Solutions At ZOLL, we're passionate about improving patient outcomes and helping save lives. We prov...
  • 12 Days Ago

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Customer Insights Manager
  • Aptitude Medical Systems, Inc.
  • Santa Barbara, CA FULL_TIME
  • Job DescriptionJob title: Customer Insights ManagerJob statement: This role reports to the COO. This role will assist in customer discovery and market research, design and conduct voice of customer su...
  • 1 Month Ago

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Lean Manager - Continuous Improvement
  • Freudenberg Medical LLC
  • Carpinteria, CA FULL_TIME
  • Freudenberg is a global technology group that strengthens its customers and society long-term through forward-looking innovations. Together with our partners, customers and the world of science, we de...
  • 1 Month Ago

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Medical Receptionist
  • Jackson Medical Group
  • Goleta, CA FULL_TIME
  • Busy Internal Medicine practice with several offices in South Santa Barbara County area is seeking a smart, energetic, self-starter for a full-time, front office position in a busy medical clinic. Bil...
  • 29 Days Ago

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0 Medical Claims Review Manager jobs found in Santa Barbara, CA area

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Physician Assistant (PA-C)
  • The Spine and Orthopedic Center
  • Santa Barbara, CA
  • Physician Assistant About The Spine and Orthopedic Center The Spine and Orthopedic Center is a well-established and busy...
  • 4/24/2024 12:00:00 AM

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RN Case Manager - REMOTE
  • Actalent
  • Santa Barbara, CA
  • Non-profit healthcare network is looking for a registered nurse case manager to join their team on a contract basis! Opp...
  • 4/24/2024 12:00:00 AM

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Job Coach, Project SEARCH
  • PathPoint
  • Santa Barbara, CA
  • Do you enjoy teaching others and seeing them succeed? Are you passionate about empowering people with disabilities to ac...
  • 4/24/2024 12:00:00 AM

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Group Exercise Instructor
  • Gold's Gym
  • Santa Barbara, CA
  • Why is it great to work here? Gold's Gym is growing fast and looking for a Group Exercise Instructor to help us to provi...
  • 4/23/2024 12:00:00 AM

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Extra Help Court Interpreter - Spanish
  • Superior Court of California, County of Santa Barbara
  • Santa Barbara, CA
  • Salary: $339.92 - $389.28 Daily Location : Santa Barbara County, CA Job Type: Extra Help (temporary) Job Number: 2401CIS...
  • 4/23/2024 12:00:00 AM

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Adult Psychiatrist - Santa Barbara, CA
  • LifeStance Health
  • Santa Barbara, CA
  • 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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Child Adolescent Psychiatrist- Hybrid Schedule! - Santa Barbara, CA
  • LifeStance Health
  • Santa Barbara, CA
  • 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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Physician Assistant (PA-C)
  • The Spine And Orthopedic Center
  • Santa Barbara, CA
  • Physician Assistant About The Spine and Orthopedic Center The Spine and Orthopedic Center is a well-established and busy...
  • 4/21/2024 12:00:00 AM

Santa Barbara (Spanish: Santa Bárbara) is the county seat of Santa Barbara County in the U.S. state of California. Situated on a south-facing section of coastline, the longest such section on the West Coast of the United States, the city lies between the steeply rising Santa Ynez Mountains and the Pacific Ocean. Santa Barbara's climate is often described as Mediterranean, and the city has been promoted as the "American Riviera". As of 2014, the city had an estimated population of 91,196, up from 88,410 in 2010, making it the second most populous city in the county after Santa Maria. The contig...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$105,378 to $134,358
Santa Barbara, California area prices
were up 2.5% 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