Medical Claims Review Manager jobs in Hawaii

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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HI- 1099 Property Claims Adjuster
  • Copper Claims Services, Inc.
  • Honolulu, HI 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 Hawaii 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: $15.00 - $23.00 per hour

    Schedule:

    • 8 hour shift

    Work Location: On the road

  • 21 Days Ago

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Manager, Claims Processing
  • Hawaii Dental Service
  • Honolulu, HI FULL_TIME
  • POSITION SUMMARYResponsible for the efficient and effective operations of the Claims department. Performs duties and responsibilities that include managing a team of both exempt and non-exempt employe...
  • 2 Days Ago

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Workers Compensation Claims Manager
  • ProService Hawaii
  • Honolulu, HI FULL_TIME
  • JOIN OUR PROHANA Listed as one of Hawaii's Best Places to Work for over 17 years and Hawaii's Top 250 Businesses, at ProService our PROhana isn't just your co-workers, it's your community. Being a mem...
  • 2 Days Ago

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Medical Office Manager
  • Medical office
  • Kailua, HI FULL_TIME
  • Experienced medical office manager needed to run our Primary Care office.You should demonstrate excellent organizational skills, be able to handle multiple tasks with personnel, patients, insurance is...
  • 18 Days Ago

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Workers Compensation Claims Team Lead | Honolulu, HI (In-Office)
  • Sedgwick Claims Management Services Inc.
  • Honolulu, HI FULL_TIME
  • Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flex...
  • 3 Days Ago

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Security Guard
  • Resident Manager AOAO
  • Honolulu, HI FULL_TIME
  • Job description Resident Manager AOAO is looking for a Security Guard to join our team in Honolulu, HI. Position Overview: The Security Guard will be responsible for maintaining a safe and secure envi...
  • 1 Month Ago

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Hospital Medical Leader
  • Petco
  • Fairfield, CA
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 6/10/2024 12:00:00 AM

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Hospital Medical Leader
  • Petco
  • Deerfield Beach, FL
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 6/9/2024 12:00:00 AM

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Hospital Medical Leader
  • Petco Animal Supplies Inc
  • Noblesville, IN
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 6/9/2024 12:00:00 AM

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Hospital Medical Leader
  • Petco Animal Supplies Inc
  • Alameda, CA
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 6/9/2024 12:00:00 AM

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Head of Medical Writing
  • Barrington James
  • Clinical-stage biopharmaceutical company in San Francisco, is seeking a Head of Medical Writing. This leadership role in...
  • 6/8/2024 12:00:00 AM

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Head of Medical Strategy
  • ExecuSearch
  • Atlanta, GA
  • The Head of Medical Strategy provides medical expertise to the rheumatology commercial and medical teams and provides cl...
  • 6/8/2024 12:00:00 AM

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Head of Medical Writing
  • Barrington James
  • San Francisco, CA
  • Head of Medical Writing - Rare disease Biotech We are currently partnered with a growing, west coast based biotech focus...
  • 6/7/2024 12:00:00 AM

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Hospital Medical Leader
  • Petco Animal Supplies, Inc.
  • Plainview, NY
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 6/7/2024 12:00:00 AM

Hawaii (/həˈwaɪi/ (listen) hə-WY-ee; Hawaiian: Hawaiʻi [həˈvɐjʔi]) is the 50th and most recent state to have joined the United States, having received statehood on August 21, 1959. Hawaii is the only U.S. state located in Oceania, the only U.S. state located outside North America, and the only one composed entirely of islands. It is the northernmost island group in Polynesia, occupying most of an archipelago in the central Pacific Ocean. The state encompasses nearly the entire volcanic Hawaiian archipelago, which comprises hundreds of islands spread over 1,500 miles (2,400 km). At the southea...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$102,435 to $130,606

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