Medical Claims Review Manager jobs in Boise, ID

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)

B
Department Manager - Claims and Customer Service
  • Best Life and Health Insurance Company
  • Meridian, ID FULL_TIME
  • Job description

    For more than 50 years, BEST Life and Health Insurance Company has been one of the nation’s leading insurance carriers specializing in ancillary employee benefit plans and individual ACA dental. We are currently seeking a Claims and Customer Service Manager to work full-time in our newly remodeled Corporate Offices located in Meridian, Idaho. The top applicant will have a minimum 3 years of customer service experience in a call center environment and at least 1 year in a supervisory role or lead position. If you meet any of these qualifications and want to work with the BEST company in the Boise, ID area, please send us your resume!

    SUMMARY:

    This position will ensure claims and customer service teams function with a high level of efficacy by supervising customer service and claims staff. Lead and manage the day-to-day customer service activities of providing services to members, healthcare providers, plan administrators and brokerage community using available systems and timely communication with staff in Idaho and California by performing the following duties.

    ESSENTIAL DUTIES AND RESPONSIBILITIES:

    · Provide excellent service to claims examiners in the day-to-day claims support functions and assists claims leadership with various duties, projects, training events and administrative functions as requested.

    · Give clear and concise direction to customer service representatives in day-to-day duties.

    · Facilitate training for new hires and existing staff.

    · Offer feedback to staff regarding performance of duties.

    · Suggest improvements to processes for the office and staff.

    · Manage and review new hire selections and performance review.

    · Handle escalated call situations.

    · Develops and implements clear procedures and processes related to Customer Service Department, Claims Department , office and other areas as needed

    · Ensures operation efficiency of office staff as needed; oversees communications and strategic planning related to office administration

    · Manages facility in coordination with other departments, including all aspects of office space/infrastructure for office building (eg., inside and outside appearance, moves, changes, etc..) vendor contracts and relationships

    · Manages office supplies

    · Weekly and monthly reporting

    · Other duties as assigned.

    EDUCATION/EXPERIENCE: Educational degrees must be from a US Department of Education accredited school.

    · High School Diploma AND

    · At least one (1) year experience in the medical/health/life insurance industry

    · At least three (3) years of customer service experience in a call center environment with minimum of 1 year supervisor or lead position.

    · Two (2) year college (Associate’s Degree).

    · Knowledge of HIPAA regulations preferred.

    · Spanish speaking a plus, but not required.

    Office Manager Qualifications/Skills:

    · Must have good communication skills and be able to work closely with our Executive team and employees.

    · Delegation

    · Staffing

    · Promoting process improvement

    · Reporting Skills

    · Comply with all safety policies, practices and procedures. Report all unsafe activities to supervisor and/or Human Resources.

    · Provide leadership to others through example and sharing of knowledge/skill.

    · Strong organization skills.

    · Ability to work under pressure in high volume area, and meet strict deadlines.

    · Ability to work independently with great sense of urgency.

    Benefits of working with us include:

    • 11 Company Paid Holidays
    • Competitive Wages
    • Benefits: Medical, Dental, Vision and Life Insurance
    • Short Term & Long Term Disability Coverage at no cost to our employees
    • 120 hours of Paid Time Off
    • 401k Matching $$$

    Job Type: Full-time

    Pay: From $75,000.00 per year

    Benefits:

    • 401(k)
    • 401(k) matching
    • Dental insurance
    • Employee assistance program
    • Health insurance
    • Health savings account
    • Paid time off
    • Vision insurance

    Physical setting:

    • Call center
    • Office

    Schedule:

    • 8 hour shift
    • Day shift
    • Monday to Friday

    Ability to commute/relocate:

    • Meridian, ID 83642: Reliably commute or willing to relocate with an employer-provided relocation package (Required)

    Experience:

    • Office management: 2 years (Preferred)
    • Customer service: 1 year (Preferred)

    Work Location: In person

  • 20 Days Ago

C
ID -1099 - Property Field Adjuster
  • Copper Claims Services, Inc.
  • Boise, ID FULL_TIME
  • 1099 Property Field Adjuster Copper Claims Services is a quickly growing independent loss adjusting firm based out of Irvine, CA with offices in California, Arizona, Oregon, Nevada, Washington, Utah, ...
  • 28 Days Ago

T
Claims- Field Claims Representative
  • The Cincinnati Insurance Companies
  • Boise, ID FULL_TIME
  • US-ID-Boise Description Make a difference with a career in insurance At The Cincinnati Insurance Companies, we put people first and apply the Golden Rule to our daily operations. To put this into acti...
  • 1 Day Ago

I
OFFICE MANAGER
  • Innovation Medical Group
  • Meridian, ID FULL_TIME
  • Position Description: The Practice Manager is responsible for the day-to-day operation of the practice. Coordinating office activities and operations to secure efficiency and compliance to company pol...
  • 10 Days Ago

S
Clinic Manager
  • STERLING MEDICAL LLC
  • Meridian, ID OTHER
  • Job Details Job Location: Sterling Urgent Care Meridian Ustick - Meridian , ID Salary Range: Undisclosed Description Job Title: Clinic Manager Supervisor: Clinic Director Are you a passionate healthca...
  • 11 Days Ago

P
Paid Product Tester
  • Product Review Jobs
  • LUCILE, ID 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

Filters

Clear All

Filter Jobs By Location
  • Filter Jobs by companies
  • More

0 Medical Claims Review Manager jobs found in Boise, ID area

H
Remote Licensed Mental Health Counselor
  • Headway
  • Meridian, ID
  • Remote Licensed Mental Health Counselor (LMHC) Wage: Between $120-$131 an hour Are you a Licensed Mental Health Counselo...
  • 3/28/2024 12:00:00 AM

H
Remote Licensed Clinical Social Worker
  • Headway
  • Boise, ID
  • Remote Licensed Clinical Social Worker (LCSW) Wage: Between $120-$131 an hour Are you a Licensed Clinical Social Worker ...
  • 3/28/2024 12:00:00 AM

H
Remote Licensed Clinical Psychologist
  • Headway
  • Boise, ID
  • Remote Licensed Clinical Psychologist Wage: Between $166-$196 an hour Are you a Licensed Clinical Psychologist looking t...
  • 3/28/2024 12:00:00 AM

S
Pediatric Mental Health Therapist
  • St. Luke's Health System
  • Boise, ID
  • Overview St. Luke's Health System in Boise is seeking a Mental Health Therapist to join our Outpatient Pediatric Mental ...
  • 3/28/2024 12:00:00 AM

H
Remote Licensed Mental Health Counselor
  • Headway
  • Boise, ID
  • Remote Licensed Mental Health Counselor (LMHC) Wage: Between $120-$131 an hour Are you a Licensed Mental Health Counselo...
  • 3/28/2024 12:00:00 AM

H
Remote Licensed Clinical Psychologist
  • Headway
  • Meridian, ID
  • Remote Licensed Clinical Psychologist Wage: Between $166-$196 an hour Are you a Licensed Clinical Psychologist looking t...
  • 3/28/2024 12:00:00 AM

H
Remote Licensed Clinical Social Worker
  • Headway
  • Meridian, ID
  • Remote Licensed Clinical Social Worker (LCSW) Wage: Between $120-$131 an hour Are you a Licensed Clinical Social Worker ...
  • 3/28/2024 12:00:00 AM

C
Registered Nurse - Weekend Supervisor
  • Cascadia Healthcare
  • Boise, ID
  • Position Summary: The primary role of the Registered Nurse (Weekend Supervisor) is to supervise staff, monitor patients,...
  • 3/27/2024 12:00:00 AM

Boise (/ˈbɔɪsi/ (listen)) is the capital and most populous city of the U.S. state of Idaho, and is the county seat of Ada County. Located on the Boise River in southwestern Idaho, the population of Boise at the 2010 Census was 205,671, the 99th largest in the United States. Its estimated population in 2016 was 223,154. Boise is in southwestern Idaho, about 41 miles (66 km) east of the Oregon border, and 110 miles (177 km) north of the Nevada border. The downtown area's elevation is 2,704 feet (824 m) above sea level. Most of the metropolitan area lies on a broad, flat plain, descending to the ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$90,661 to $115,594
Boise, Idaho 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