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)
100% Remote, Work-From-Home position anywhere in the US. (Any state RN license is accepted).
As an RN, you will provide direction, guidance, and support to our physician Medical Claims Reviewers as well as other staff as indicated. Complete quality audits of individual case reviews.
Support the clinical aspects of the review process and case reviews, including but not limited to:
Qualifications:
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0 Medical Claims Review Manager jobs found in Springfield, MO area