Medical Claims Review Manager jobs in Santa Fe, NM

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 Manager
  • Flux Resources, LLC
  • Las Vegas, NM FULL_TIME
  • Job Responsibilities
    • Overall resource management, supervision, and policy implementation and enforcement for employees who are deployed to a disaster and are working within a FEMA organizational chart at the client site. This includes ability to lead and work effectively with others, deliver constructive and honest feedback, and effectively communicate to team and/or supervisors in open and timely manner.
    • Understanding and managing team to work within the contractual scope, schedule and budget, including financial management and reporting requirements.
    • Management of conflict of interest for the work being performed at disaster location.
    • Employee staffing, including backfills and assisting with new hire orientation training and logistics.
    • Assist in resolution of employee questions, problems and complaints in partnership with Human Resources and Client.
    • Management of employee resources and training needed to deliver quality work in a safe and healthy working environment.
    • Using data to track and manage workloads to meet client deadlines and to report progress in a timely manner.

    Requirements:
    • Bachelor's degree.
    • 10 years of related experience.
    • Domestic and/or international travel may be required. The frequency of travel is contingent on specific duties, responsibilities, and the essential functions of the position, which may vary depending on workload and project demands.
    • Previous experience with disaster recovery or insurance adjusting preferred
    • Claims Experience preferred
    • Equivalent additional directly related experience will be considered in lieu of a degree.
    #LI-AL1
    Flux is an Equal Opportunity Employer that values diversity in our workplace. We welcome all qualified applicants regardless of race, color, sex, age, religion, national origin, physical or mental disability, pregnancy, marital status, veteran or military status, genetic information or sexual orientation.

     

  • 1 Month Ago

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Paid Product Tester
  • Product Review Jobs
  • La Plata, NM 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...
  • Just Posted

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Paid Product Tester
  • Product Review Jobs
  • Vadito, NM 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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Paid Product Tester
  • Product Review Jobs
  • OCATE, NM 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...
  • 27 Days Ago

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Paid Product Tester
  • Product Review Jobs
  • Cimarron, NM 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...
  • 27 Days Ago

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Paid Product Tester
  • Product Review Jobs
  • UTE PARK, NM 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...
  • 27 Days Ago

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0 Medical Claims Review Manager jobs found in Santa Fe, NM area

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Nurse Practitioner - Pain & Spine
  • Christus Health
  • Santa Fe, NM
  • Description Our team is seeking a full time experienced nurse practitioner to provide, assist and support physicians and...
  • 4/24/2024 12:00:00 AM

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Nurse Practitioner - Pain & Spine
  • CHRISTUS Health
  • Santa Fe, NM
  • Description Our team is seeking a full time experienced nurse practitioner to provide, assist and support physicians and...
  • 4/24/2024 12:00:00 AM

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Remote Licensed Clinical Social Worker
  • Headway
  • Santa Fe, NM
  • Remote Licensed Clinical Social Worker (LCSW) Wage: Between $95-$130 an hour Are you a Licensed Clinical Social Worker l...
  • 4/21/2024 12:00:00 AM

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Remote Licensed Clinical Psychologist
  • Headway
  • Santa Fe, NM
  • Remote Licensed Clinical Psychologist Wage: Between $95-$174 an hour Are you a Licensed Clinical Psychologist looking to...
  • 4/21/2024 12:00:00 AM

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Remote Licensed Mental Health Counselor
  • Headway
  • Santa Fe, NM
  • Remote Licensed Mental Health Counselor (LMHC) Wage: Between $95-$130 an hour Are you a Licensed Mental Health Counselor...
  • 4/21/2024 12:00:00 AM

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Remote Licensed Professional Counselor
  • Headway
  • Santa Fe, NM
  • Remote Licensed Professional Counselor (LPC) Wage: Between $95-$130 an hour Are you a Licensed Professional Counselor lo...
  • 4/21/2024 12:00:00 AM

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Remote Licensed Marriage and Family Therapist
  • Headway
  • Santa Fe, NM
  • Remote Licensed Marriage and Family Therapist (LMFT) Wage: Between $95-$130 an hour Are you a Licensed Marriage and Fami...
  • 4/21/2024 12:00:00 AM

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Remote Licensed Mental Health Therapist
  • Headway
  • Santa Fe, NM
  • Remote Licensed Mental Health Therapist (LMHT) Wage: Between $95-$130 an hour Are you a Licensed Mental Health Therapist...
  • 4/21/2024 12:00:00 AM

Santa Fe (/ˌsæntəˈfeɪ/ or /ˈsæntəˌfeɪ/; Tewa: Oghá P'o'oge, Navajo: Yootó) is the capital of the U.S. state of New Mexico. It is the fourth-largest city in the state and the seat of Santa Fe County. This area was occupied for at least several thousand years by indigenous peoples who built villages several hundred years ago, on the current site of the city. It was known by the Tewa inhabitants as Ogha Po'oge ("White Shell Water Place"). The city of Santa Fe, founded by Spanish colonists in 1610, is the oldest state capital in the United States. Santa Fe (meaning "holy faith" in Spanish) had a p...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$92,205 to $117,563
Santa Fe, New Mexico 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