Medical Claims Review Manager jobs in Trenton, NJ

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)

V
Sales Manager North
  • VERUS CLAIMS SERVICES LLC
  • Princeton, NJ FULL_TIME
  • Description

    SUMMARY:


    The Sales Manager North plays a crucial role in driving revenue and achieving sales targets for the company with a primary focus on the North market of the United States. With a hunter mentality, the Sales Manager North is involved in developing and implementing effective sales strategies and setting sales targets to achieve their goals in the legal mass tort industry and is responsible for maintaining strong relationships with key clients, forecasting sales projections, and presenting sales reports/data to senior management. The Sales Manager North collaborates with Verus’ Business Units as well as other departments to align sales efforts with company objectives and continuously improves the sales process. Strong leadership, communication, analytical thinking, business acumen and negotiation skills are essential in this dynamic and goal-oriented role.


    Primary Responsibilities

    • Develops and implements effective sales strategies and tactics to achieve company goals and objectives across Verus’ two business areas (Settlement Administration, Case Management).
    • Analyzes market trends, identifies potential opportunities, and sets sales targets.
    • Develops, acquires, and closes new business deals with a focus on company sales/revenue projections.
    • Researches, studies, and remains up to date on legal/mass tort industry standards, market trends, competitor activities.
    • Forecasts sales and tracks sales performance regularly in Salesforce (CRM system).
    • Works closely with Marketing and Business Units on the definition of sales and marketing strategies that fill the company’s opportunity funnel and drive sales.
    • Prepares and presents sales reports to senior management, highlighting achievements, challenges, and recommendations.
    • Builds and maintains strong relationships with key clients and accounts. Oversees the handling of customer inquiries, complaints, and issues to ensure a high level of customer satisfaction.
    • Negotiates pricing and agreement structures.
    • Manages departmental costs to budgetary guidelines.
    • Collaborates closely with the Sales Manager South and works cross-departmentally on client documents, proposals, materials, and communications.
    • Continually identifies new sales opportunities while maintaining existing client relationships.
    • Attends industry conferences and tradeshows as part of prospecting new clients.

    Requirements

    Requirements/Competencies

    • 5-10 years of experience in B2B sales, with a proven track record of achieving targets.
    • Experience in service sales highly desired.
    • Prior experience in legal industry/mass tort preferred.
    • Bachelor’s Degree in business-related field.
    • Tenacious sales leader with a hunter mentality.
    • Proven ability to complete cold calls; quickly establish positive, trusting relationships and rapport.
    • Excellent verbal and written communication skills and interpersonal skills are crucial for building relationships with clients, presenting sales reports/data, and communicating with the team effectively.
    • Adept at analyzing data, market trends, and performance metrics to make informed decisions and develop effective strategies.
    • Proven skills to sell on value rather than price.
    • Highly goal-oriented and driven to achieve results.
    • Strong negotiation skills to close deals and handle business contracts effectively.
    • Problem-Solver with a ability to identify challenges and develop effective solutions quickly.
    • Well versed in using customer relationship management (CRM) software, such as Salesforce. Salesforce experience desired.
    • Located in Northeast and close to a major airport.

    Key Skills

    • Business Acumen
    • Analytic Skills
    • Strategic Thinking
    • Tenacity
    • Judgement/Decision Making
    • Creativity
    • Innovation
    • Organization
    • Communication
    • Leadership

    Working Conditions

    Normal office conditions, including working for prolonged periods of time at a computer screen. Frequent overnight travel up to 50% required.

  • 20 Days Ago

C
Claims Representative
  • Corporate Claims Management
  • Richboro, PA FULL_TIME,PART_TIME
  • .About Corporate Claims Management, Inc. (CCM). CCM, is entering our 31st year of business! We are a nationwide fleet management service company based in the Ivyland/Warminster soon to relocate to Ric...
  • 21 Days Ago

M
Claims Manager
  • Munich Re America
  • Princeton, NJ FULL_TIME
  • Offer:Profile:
  • 15 Days Ago

N
Manager - Contract Review and Compliance Reporting
  • Novo Nordisk
  • Plainsboro, NJ FULL_TIME
  • About the Department The Clinical, Medical and Regulatory (CMR) department at Novo Nordisk is one of the most diverse and collaborative groups within the organization. From health-care-provider intera...
  • 13 Days Ago

W
Health Claims Audit Manager
  • WithumSmith+Brown
  • Princeton, NJ FULL_TIME
  • Looking to work at a firm with an unbeatable culture? Withum is a forward-thinking, technology-driven advisory and accounting firm, helping clients to Be in a Position of StrengthSM in today’s modern ...
  • 29 Days Ago

D
RN Case Manager - Utilization Review (Per Diem)
  • Deborah Heart and Lung
  • Browns Mills, NJ PER_DIEM
  • Job Details Description Position Summary: The Utilization Review Case Manager validates the patient’s placement to be at the most appropriate level of care based on nationally accepted admission crite...
  • 6 Days Ago

Filters

Clear All

  • Filter Jobs by companies
  • More

0 Medical Claims Review Manager jobs found in Trenton, NJ area

H
Remote Licensed Clinical Social Worker
  • Headway
  • Princeton, NJ
  • Remote Licensed Clinical Social Worker (LCSW) Wage: Between $95-$130 an hour Are you a Licensed Clinical Social Worker l...
  • 4/26/2024 12:00:00 AM

H
Remote Licensed Marriage and Family Therapist
  • Headway
  • Princeton, NJ
  • Remote Licensed Marriage and Family Therapist (LMFT) Wage: Between $95-$130 an hour Are you a Licensed Marriage and Fami...
  • 4/26/2024 12:00:00 AM

H
Remote Licensed Psychiatrist
  • Headway
  • Princeton, NJ
  • Remote Licensed Psychiatrist Wage: Between $156-$263 an hour Are you a licensed Psychiatrist looking to launch a private...
  • 4/26/2024 12:00:00 AM

H
Remote Licensed Professional Counselor
  • Headway
  • Princeton, NJ
  • Remote Licensed Professional Counselor (LPC) Wage: Between $95-$130 an hour Are you a Licensed Professional Counselor lo...
  • 4/26/2024 12:00:00 AM

H
Remote Licensed Clinical Psychologist
  • Headway
  • Princeton, NJ
  • Remote Licensed Clinical Psychologist Wage: Between $95-$196 an hour Are you a Licensed Clinical Psychologist looking to...
  • 4/26/2024 12:00:00 AM

H
Remote Licensed Mental Health Counselor
  • Headway
  • Princeton, NJ
  • Remote Licensed Mental Health Counselor (LMHC) Wage: Between $95-$130 an hour Are you a Licensed Mental Health Counselor...
  • 4/26/2024 12:00:00 AM

H
Remote Licensed Mental Health Therapist
  • Headway
  • Princeton, NJ
  • Remote Licensed Mental Health Therapist (LMHT) Wage: Between $95-$130 an hour Are you a Licensed Mental Health Therapist...
  • 4/26/2024 12:00:00 AM

O
Executive Director, Medical Affairs Outcomes Research (MAOR) US Field Medical Lead
  • Organon & Co
  • Plymouth Meeting, PA
  • Job Description The Position The Executive Director, Medical Affairs Outcomes Research (MAOR) US Field Medical Lead is r...
  • 4/24/2024 12:00:00 AM

According to the United States Census Bureau, the city had a total area of 8.155 square miles (21.122 km2), including 7.648 square miles (19.809 km2) of land and 0.507 square mile (1.313 km2) of water (6.21%). Several bridges across the Delaware River – the Trenton–Morrisville Toll Bridge, Lower Trenton Bridge and Calhoun Street Bridge – connect Trenton to Morrisville, Pennsylvania, all of which are operated by the Delaware River Joint Toll Bridge Commission. Trenton is located near the exact geographic center of the state, which is 5 miles (8.0 km) located southeast of Trenton. The city is so...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$105,963 to $135,104
Trenton, New Jersey 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