Medical Claims Review Manager jobs in Oklahoma
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)
Recently Added Medical Claims Review Manager jobs
Medical Claims Examiner
- The Kempton Group Administrators
-
Oklahoma, OK
FULL_TIME
-
Job Description
Medical Claims Examiner
At The Kempton Group, we are changing the healthcare industry. We believe in transparency and we have the genuine desire to transform how employers and participants view and purchase healthcare. Kempton clients offer top-tier benefits where medical services are FREE to their employees and we have saved our clients over $100 Million in claims cost since launching the Kempton Premier Provider Program 10 years ago. The Medical Claims Examiner will be expected build and modify benefit plans in the claims adjudication system in an accurate & timely manner.
Other qualities & responsibilities include:- Excellent written and verbal communication skills
- Review benefits of prior plans for new clients
- Present benefit recommendations for plan renewals
- Audit test claims
- Run & analyze reports related to accumulators, claims paid, coverage records, etc.
- Create plan documents such as: Summary Plan Description (SPD), Account Benefits Structure (ABS), Summary of Benefits and Coverage (SBC), Schedule of Benefits (SOB), etc.
- Configure benefits to ancillary systems: IVR, member portal, provider portal, etc.
- Conduct quality control procedures
If you would like more information about the available position, please visit www.kemptongroup.com. We look forward to hearing from you!
Company Description
For 50 years, The Kempton Group Administrators, Inc. (KGA) has empowered self-funded employers to take control of their benefit plans. We encourage transparency and free market principles in every layer of healthcare. We do not promote gimmicks; we FIX your plan. Let us show you why an independent Third Party Administrator (TPA) is the right choice.
For 50 years, The Kempton Group Administrators, Inc. (KGA) has empowered self-funded employers to take control of their benefit plans. We encourage transparency and free market principles in every layer of healthcare. We do not promote gimmicks; we FIX your plan. Let us show you why an independent Third Party Administrator (TPA) is the right choice. - 5 Days Ago
Medical Management- Concurrent Review Nurse- RN 145-2018
- CommunityCare
-
Tulsa, OK
FULL_TIME
- JOB SUMMARY: Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populat...
- 22 Days Ago
Advertising Account Executive
- The Marlow Review
-
Marlow, OK
FULL_TIME
- We are seeking an Advertising Account Executive. Account execs are responsible for helping local business owners succeed through marketing in our products, including newspapers, websites, special publ...
- Just Posted
News Reporter
- The Marlow Review
-
Marlow, OK
OTHER,PART_TIME,FULL_TIME
- Reports to: Regional Editor Position Summary: Responsible for researching and writing stories on a daily basis. Also assist with writing for special sections as needed. We are excited to offer Vlog an...
- Just Posted
Warranty Claims Manager
- Goodwin Recruiting
-
Albert, OK
FULL_TIME
- To Apply for this Job Click HereOur client, a global manufacturer specializing in LED lighting drivers for a diverse range of commercial applications across the world, is actively seeking an experienc...
- 6 Days Ago
Manufacturing Claims Manager
- Goodwin Recruiting
-
Oklahoma, OK
FULL_TIME
- To Apply for this Job Click HereOur client manufactures LED lighting drivers for stadiums, bridges, horticulture facilities, and many other commercial spaces around the globe. They are looking for an ...
- Just Posted
Medical Claims Review Manager jobs at Popular Companies
Hospital Medical Leader
- Petco
-
Folsom, 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
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
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
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
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
Head of Medical Strategy Rheumatology
- UCB
-
Atlanta, GA
- Make your mark for patients The Head of Medical Strategy provides medical expertise to the rheumatology commercial and m...
- 6/8/2024 12:00:00 AM
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
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
About Oklahoma
Oklahoma is the 20th-largest state in the United States, covering an area of 69,899 square miles (181,040 km2), with 68,595 square miles (177,660 km2) of land and 1,304 square miles (3,380 km2) of water. It lies partly in the Great Plains near the geographical center of the 48 contiguous states. It is bounded on the east by Arkansas and Missouri, on the north by Kansas, on the northwest by Colorado, on the far west by New Mexico, and on the south and near-west by Texas. Much of its border with Texas lies along the Southern Oklahoma Aulacogen, a failed continental rift. The geologic figure defi...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$90,672 to $115,609
Most Popular Cities in Oklahoma for Medical Claims Review Manager Jobs
What does a Medical Claims Review Manager do?
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 examiners view of a particular bills status in a claim records related bill screen, or a bill review analysts 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