Medical Claims Review Manager jobs in Michigan

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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Healthcare Claims Specialist
  • Managed Medical Review Organization, Inc.
  • Novi, MI FULL_TIME
  • MMRO's Healthcare Review Specialist is responsible for the lifecycle of healthcare claims; including but not limited to, receiving the initial request, reviewing the case for service type and conflict of interest, confirming the appropriate paperwork, creating the report template for the Physician, referring for a medical appointment, calling claimants to get information and/or to give the determination/claim outcome.

    Experience that will help you excel in this role: organization, detail oriented, familiarity with medical terminology, scheduling medical appointments, customer service experience and medical office experience.

    If you have industry knowledge of healthcare claims, workers comp, short term disability, long term disability or RX claims, that is beneficial.

    MMRO seeks new team members who are reliable, punctual, detail oriented, respectful and contribute to a positive workplace culture.

    This position works 8am to 4pm EST in our Novi office and rotates on-call weekends for urgent cases. The average weekend work required if on call is up to 5 hours total

    Job Type: Full-time

    Pay: $42,500.00 - $45,500.00 per year

    Benefits:

    • 401(k)
    • 401(k) matching
    • Dental insurance
    • Health insurance
    • Life insurance
    • Paid time off
    • Vision insurance

    Schedule:

    • 8 hour shift
    • Monday to Friday

    Work setting:

    • In-person
    • Office

    Experience:

    • Microsoft Office: 1 year (Preferred)
    • Customer service: 1 year (Preferred)

    Ability to Commute:

    • Novi, MI 48377 (Preferred)

    Ability to Relocate:

    • Novi, MI 48377: Relocate before starting work (Required)

    Work Location: In person

  • Just Posted

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Rail Business Development Manager
  • Performance Review Institute (PRI)
  • Troy, MI FULL_TIME
  • DescriptionJoin a dynamic, entrepreneurial team working to lead the rail industry through cross-industry challenges. Collaborate with the global leaders in rail systems to develop high-impact solution...
  • 12 Days Ago

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Committee Manager - Ground Vehicle
  • Performance Review Institute (PRI)
  • Troy, MI FULL_TIME
  • DescriptionSUMMARY: This position is responsible for coordinating the work of assigned technical committees by acting as the SAE representative at appropriate committee meetings; facilitating committe...
  • 2 Months Ago

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Manager, Medical Bill Review, Hybrid Remote in Lansing, MI or Remote opportunity
  • AF Group Careers Section
  • Lansing, MI FULL_TIME
  • Hybrid Remote in Lansing, MI.Will consider candidates for a Remote opportunity. Must be able to accommodate EST office hours and reside within the U.S. Provide leadership and direction to a claims ope...
  • 2 Months Ago

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Field Case Manager
  • Sedgwick Claims Management Services Inc.
  • Grand Rapids, MI 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...
  • 1 Day Ago

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Claims Processor
  • Sheldon Medical Supply
  • Sandusky, MI FULL_TIME
  • In search of Medical Billing Specialist. Experience should include: excellent telephone etiquette, computer skills, and Insurance knowledge . Looking for someone organized with good time management. R...
  • 4 Days Ago

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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...
  • 6/2/2024 12:00:00 AM

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Hospital Medical Leader
  • Petco Health and Wellness Company, 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...
  • 6/2/2024 12:00:00 AM

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Hospital Medical Leader
  • Petco
  • Santa Rosa, CA
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 5/31/2024 12:00:00 AM

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Hospital Medical Leader
  • Petco Health and Wellness Company, Inc.
  • Saratoga Springs, UT
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 5/30/2024 12:00:00 AM

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Hospital Medical Leader
  • Petco Animal Supplies Inc
  • Folsom, CA
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 5/30/2024 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...
  • 5/29/2024 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...
  • 5/29/2024 12:00:00 AM

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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...
  • 5/29/2024 12:00:00 AM

Michigan consists of two peninsulas that lie between 82°30' to about 90°30' west longitude, and are separated by the Straits of Mackinac. The 45th parallel north runs through the state—marked by highway signs and the Polar-Equator Trail—along a line including Mission Point Light near Traverse City, the towns of Gaylord and Alpena in the Lower Peninsula and Menominee in the Upper Peninsula. With the exception of two small areas that are drained by the Mississippi River by way of the Wisconsin River in the Upper Peninsula and by way of the Kankakee-Illinois River in the Lower Peninsula, Michigan...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$96,529 to $123,075

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