Medical Claims Review Manager jobs in Connecticut
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
Field Case Manager
- Sedgwick Claims Management Services Inc.
-
Hartford, CT
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 flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive. A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work. Great Place to Work® Most Loved Workplace® Forbes Best-in-State Employer Field Case Manager This Field Case Manager will cover our Hartford, CT region and must live in this area in order to be considered. PRIMARY PURPOSE OF THE ROLE: Sedgwick Field Case Managers work face to face with their injured workers and medical providers to facilitate; though advocacy, progressive medical treatment, and timely return to work; while acting as a liaison and providing communication between all involved parties. While frequent travel is required, you will maintain a home based office. ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work. Apply your medical/clinical or rehabilitation knowledge and experience to assist in the management of complex medical conditions, treatment planning and recovery from illness or injury. Work in the best of both worlds - a rewarding career making an impact on the health and lives of others, and a remote work environment that allows face to face interaction with injured workers and medical professionals. . Enjoy flexibility and autonomy in your daily work, your location, and your career path while advocating for the most effective and efficient medical treatment for injured employees in a non-traditional setting. Enable our Caring counts® mission supporting injured employees from some of the world’s best brands and organizations. Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. Celebrate your career achievements and each other through professional development opportunities, continuing education credits, team building initiatives and more. Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs. . ESSENTIAL RESPONSIBLITIES MAY INCLUDE Serve as patient advocate to support, guide and coordinate care for injured workers, families and caregivers as they navigate through the recovery process. Assist injured workers in achieving recovery and autonomy through advocacy, communication, education, identification of service resources and service facilitation. Identify appropriate providers and facilities throughout the continuum of services, while ensuring that available resources are being used in a timely and cost-effective manner in order to obtain optimum value for both the client and the reimbursement source EDUCATION AND LICENSING RN licensure preferred; or graduate degree in health or human services field required with one of the following certifications: CCM, CDMS, or CRC. Valid driver’s license required. High speed internet required. TAKING CARE OF YOU BY Offering flexibility and autonomy. Supporting meaningful work that promotes critical thinking and problem solving. Providing on-going learning and professional growth opportunities. Promoting a strong team environment and a culture of support. Recognizing your successes and celebrating your achievements. We offer a diverse and comprehensive benefits including medical, dental vision, 401K, PTO and more beginning your first day. NEXT STEPS If your application is selected to advance to the next round, you will receive an e-mail notification with instructions and a link to complete a recorded video interview. Upon completion and submission of the video interview, a recruiter will be in touch. #NURSE #FIELDCASEMANAGER Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles. Taking care of people is at the heart of everything we do. Caring counts Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts. Watch this video to learn more about us.
- 10 Days Ago
Credit review manager
- Bank of America
-
East Hartford, CT
FULL_TIME
- Description At Bank of America, we are guided by a common purpose to help make financial lives better through the power of every connection. Responsible Growth is how we run our company and how we del...
- 7 Days Ago
Utilization Review Case Manager
- Silver Hill Hospital
-
Canaan, CT
FULL_TIME
- Utilization Review Case Manager The UR Case Manager will complete prior authorizations and concurrent reviews for new admissions or existing patients. The UR Case Manger will work with insurance compa...
- 23 Days Ago
Claims Manager
- Henkel
-
Rocky Hill, CT
FULL_TIME
- At Henkel, you can build on a strong legacy and leading positions in both industrial and consumer businesses to reimagine and improve life every day. If you love challenging the status quo, join our c...
- 8 Days Ago
Claims Manager
- Henkel group
-
Rocky Hill, CT
FULL_TIME
- At Henkel, you can build on a strong legacy and leading positions in both industrial and consumer businesses to reimagine and improve life every day. If you love challenging the status quo, join our c...
- 2 Months Ago
Lead Medical Claims Specialist
- Complete Staffing Solutions
-
Glastonbury, CT
FULL_TIME
- We have partnered with a leading 3rd party insurance company in Glastonbury who is looking to hire 2 individuals with solid medical claims experience. Lead – 4 years of experience and has overseen a s...
- 5 Days Ago
Medical Claims Review Manager jobs at Popular Companies
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
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 Connecticut
Connecticut is bordered on the south by Long Island Sound, on the west by New York, on the north by Massachusetts, and on the east by Rhode Island. The state capital and fourth largest city is Hartford, and other major cities and towns (by population) include Bridgeport, New Haven, Stamford, Waterbury, Norwalk, Danbury, New Britain, Greenwich, and Bristol. Connecticut is slightly larger than the country of Montenegro. There are 169 incorporated towns in Connecticut.The highest peak in Connecticut is Bear Mountain in Salisbury in the northwest corner of the state. The highest point is just east...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$105,278 to $134,231
Most Popular Cities in Connecticut 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