Medical Claims Review Manager jobs in Maine

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)

C
ME - 1099 Property Claims Adjuster
  • Copper Claims Services, Inc.
  • Portland, ME FULL_TIME
  • 1099 Property Claims Adjuster

    Copper Claims Services is a quickly growing independent loss adjusting firm based out of Irvine, CA.

    Copper Claims Services excels in providing custom claims solutions for Property and Casualty, Transportation and High Net Worth, with an emphasis on Specialized Programs.

    We are currently looking for licensed adjusters (or individuals who will obtain their license upon onboarding) to assist with daily claims handling for the Maine area. In this role, you will manage, investigate and resolve homeowner and commercial property losses of moderate to severe complexity with minimal supervision to include completing field investigations, evaluating and analyzing coverage, completing property damage estimates, reporting findings to various clients, and handling files to the conclusion of the claim.

    In this role, you will:

    • Handle claims during local catastrophes
    • Complete field investigations including inspections, interviews, preparing diagrams, taking photographs, and various other tasks
    • Analyze insurance coverage issues on specific claims and make appropriate recommendations to our clients
    • Prepare detailed estimates in Xactimate based on our client’s specifications and parameters
    • Prepare clear, concise, and timely narrative reports for our clients
    • Create ITV reports
    • Evaluate co-insurance calculations and penalties if applicable
    • Maintain continuous and professional communication with our clients to ensure their needs are being met.
    • Analyze and evaluate damages including reserves, property estimates, business personal property inventories, business interruption, and business income losses
    • Investigate, analyze, adjust and negotiate settlements with insured’s in compliance with our client’s direction
    • Coordinate and oversee vendors such as emergency service contractors, origin and cause investigators, general contractors, engineers, etc.

    Qualifications:

    • 5 years of field Property adjusting experience
    • Ability to climb ladders/Access roofs
    • Thorough knowledge and understanding of roofing, HVAC, and various other mechanical specialties
    • Knowledge of Commercial Lines insurance policies
    • Proficient in Xactimate including Sketch
    • Previous experience with Xactanalysis preferred
    • Proficient in Microsoft Office (Word, Excel, and Outlook)
    • Effective negotiation skills
    • Ability to effectively and independently manage workload
    • Proven ability to provide exceptional customer service
    • Strong written and verbal communication skills
    • Exceptional organization and time management skills

    Job Type: Full-time

    Pay: $30.00 - $35.00 per hour

    Schedule:

    • 8 hour shift
    • Monday to Friday

    Ability to Relocate:

    • Portland, ME: Relocate before starting work (Required)

    Work Location: On the road

  • 1 Month Ago

M
Care Manager (RN) - Utilization Review
  • MaineHealth
  • Portland, ME FULL_TIME
  • Summary This is a bargaining unit position Date posted: 01/30/2024 For a limited time MaineHealth is offering up to $10,000 Sign on bonus for all eligible experienced Registered Nurses with 1-3 years ...
  • 27 Days Ago

W
Registered Nurse (RN) Care Manager - Utilization Review
  • Waldo County General Hospital
  • Belfast, ME FULL_TIME
  • For a limited time MaineHealth is offering up to a $10,000 Sign on bonus for all eligible experienced Registered Nurses with 0-3 years of experience and $20,000 for experienced Registered Nurses with ...
  • 16 Days Ago

M
Registered Nurse (RN) Care Manager - Utilization Review
  • MaineHealth
  • Belfast, ME FULL_TIME
  • Summary For a limited time MaineHealth is offering up to a $10,000 Sign on bonus for all eligible experienced Registered Nurses with 0-3 years of experience and $20,000 for experienced Registered Nurs...
  • 15 Days Ago

M
RN Care Manager, Care Coordination, Discharge Planning and Utilization Review
  • MaineHealth
  • Biddeford, ME FULL_TIME
  • Summary For a limited time MaineHealth is offering sign on bonuses for Registered Nurses: Registered Nurses with more than 3 years of experience: $20,000 (full time) Eligible candidates are hired into...
  • 13 Days Ago

H
Roof Technician
  • Hancock Claims Consultants Technicians
  • Portland, ME CONTRACTOR
  • CLIMB to New Heights…And live the American Dream. Become part of something bigger by contracting with the nation’s top provider of roof and property inspection services working with insurance carriers...
  • Just Posted

A
Head of Medical Writing
  • Aerovate Therapeutics Inc.
  • Waltham, MA
  • Aerovate (AVTE) is a clinical stage biopharmaceutical company focused on developing drugs that meaningfully improve the ...
  • 4/26/2024 12:00:00 AM

P
Veterinarian - Hospital Medical Leader
  • Petco Animal Supplies Inc
  • Montclair, NJ
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 4/26/2024 12:00:00 AM

H
Regional Medical Lead
  • HeartFlow, Inc
  • New York, NY
  • HeartFlow, Inc. is a medical technology company advancing the diagnosis and management of coronary artery disease, the #...
  • 4/26/2024 12:00:00 AM

P
US Pneumococcal Adult Medical Lead, MD
  • Pfizer
  • New York, NY
  • ROLE SUMMARY Provide pneumococcal franchise leadership on behalf of Asset Medical Affairs team. * Collaborates with Bran...
  • 4/26/2024 12:00:00 AM

I
Medical Director, Medical Management
  • Imperial Health Plan Of California Inc.
  • Pasadena, CA
  • People are the most important asset of Imperialfor this reason the difference and plurality of people, equality of oppor...
  • 4/26/2024 12:00:00 AM

A
Head of Medical Writing
  • Aerovate Therapeutics, Inc.
  • Waltham, MA
  • Aerovate (AVTE) is a clinical stage biopharmaceutical company focused on developing drugs that meaningfully improve the ...
  • 4/25/2024 12:00:00 AM

B
Assistant-Certified Medical Lead
  • Baptist Memorial
  • Memphis, TN
  • Summary Provides personal care assistance to patients under the direction of licensed personnel and /or Administrator. P...
  • 4/25/2024 12:00:00 AM

P
Hospital Medical Leader
  • Petco
  • Baldwin, NY
  • Create a healthier, brighter future for pets, pet parents and people!If you want to make a real difference, create an ex...
  • 4/23/2024 12:00:00 AM

To the south and east is the Atlantic Ocean and to the north and northeast is New Brunswick, a province of Canada. The Canadian province of Quebec is to the northwest. Maine is both the northernmost state in New England and the largest, accounting for almost half of the region's entire land area. Maine is the only state in the continental US to border only one other American state (New Hampshire to the South and West). Maine is the easternmost state in the United States in both its extreme points and its geographic center. The town of Lubec is the easternmost organized settlement in the United...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$94,937 to $121,047

Medical Claims Review Manager in Parkersburg, WV
This end-to-end e-billing and e-payment solution is fully integrated with DecisionPoint, which means it can be immediately and easily integrated with your providers, adjusters, IT infrastructure, and claims workflow—enabling you to.
January 01, 2020
Medical Claims Review Manager in Juneau, AK
Examples include a claims examiner’s view of a particular bill’s status in a claim record’s related bill screen, or a bill review analyst’s view of an available reserve amount for the claim record related to the bill they are processing.
December 03, 2019
Medical Claims Review Manager in Galveston, TX
Assists the Manager, Medical Review with performing duties to oversee day-to-day activities within the Medical Claims Review Department to facilitate the achievement of business goals and targets.
December 16, 2019