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)

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Customer Relations Manager
  • Claims Management Resources Inc
  • Oklahoma, OK FULL_TIME
  • The Customer Relations Manager oversees and is responsible for maintaining healthy customer relationships. Additionally, they serve as a primary contact person for resolving claim issues for customers. This position requires extensive interaction with customers, both internally and externally. This person must be flexible and dedicated with a passion for serving customers with integrity, a strong attention to detail, and ability to manage multiple projects at once.

    Duties and Responsibilities:

    • Acts as a proactive, in-house customer liaison; maintaining frequent communications and needs analysis for current customers.
    • Responds to customer requests for claims and settlement information.
    • Assists Sales/Marketing department in establishing and maintaining relationships with potential customers.
    • Creates reports, conducts data analysis and communicates results/conclusions to management and customers.
    • Conducts customer satisfaction surveys.
    • Manages, conducts and oversees monthly scheduled customer conference calls.
    • Serves as the operational or primary contact with customers.
    • Assist with new customer on-boarding transitions.
    • Lead projects to increase claims and create program/process efficiencies.
    • Researches and resolves claim issues by conferring with internal staff, and determines/offers resolutions to internal personnel and customer representatives.
    • Receives and reviews claim settlement offers, within customer relations settlement authority, and forwards requests to customers beyond internal settlement authority parameters.

    Required Skills:

    • Ability to think creatively
    • Proficient in Microsoft Office suite: Word, Teams, PowerPoint, Excel and Outlook
    • Ability to jump from high profile projects to lower profile-type projects
    • Strong communicator with ability to articulate ideas, both written and verbal
    • Strong analytical and problem-solving skills
    • Strong customer service skills including ability to engage with customers in meaningful ways
    • Ability to work independently and with minimal structure
    • Ability to identify and address acute issues and challenges
    • Available for light travel

    Education/Experience:

    • Associate’s Degree in related field required; Bachelor's degree preferred
    • 3 years of sales/marketing experience required.
    • 5 years in high level client services and/or sales/marketing experience are preferred.
  • Just Posted

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Property Insurance Claims Adjuster - Work From Home!
  • Claims Management Resources Inc
  • Oklahoma, OK FULL_TIME
  • Are you interested in working for a company that not only “talks the talk” but “walks the walk”? Lucrative Compensation Plan! Starting base of $15.00 per hour, PLUS monthly bonus! Do you thrive in a c...
  • 19 Days Ago

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Property Insurance Claims Adjuster - Work From Home!
  • CLAIMS MANAGEMENT RESOURCES INC
  • Oklahoma, OK OTHER
  • Job Details Job Location: Remote - Oklahoma City, OK Salary Range: $11.54 - $15.00 Hourly DescriptionAre you interested in working for a company that not only “talks the talk” but “walks the walk”? Lu...
  • 1 Month Ago

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Medical Claims Technician I
  • Red Rock Behavioral Health Services
  • Oklahoma, OK FULL_TIME
  • SummaryResearches insurance claim denials, determines the validity of the claim and when appropriate is responsible for adjusting and resubmitting the claims via multiple methods.Essential FunctionsRe...
  • 24 Days Ago

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Medical Claims Technician I
  • Oklahoma Mental Health Council dba Red Rock...
  • Oklahoma, OK FULL_TIME
  • SummaryResearches insurance claim denials, determines the validity of the claim and when appropriate is responsible for adjusting and resubmitting the claims via multiple methods.Essential FunctionsRe...
  • 1 Day Ago

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Medical Claims Technician I
  • Red Rock Behavioral Health Service
  • Oklahoma, OK FULL_TIME
  • SummaryResearches insurance claim denials, determines the validity of the claim and when appropriate is responsible for adjusting and resubmitting the claims via multiple methods.Essential FunctionsRe...
  • 1 Day Ago

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Head of Medical Writing
  • Morgan Prestwich - Life Science & Healthcare Executive Search
  • Company Overview Morgan Prestwich is thrilled to be representing our client on an exclusive basis. Our client is a clini...
  • 3/29/2024 12:00:00 AM

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Hospital Medical Leader
  • Petco Animal Supplies Inc
  • Orem, UT
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 3/28/2024 12:00:00 AM

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Hospital Medical Leader
  • Petco Animal Supplies Inc
  • Fairfield, CA
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 3/28/2024 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...
  • 3/28/2024 12:00:00 AM

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Medical Lead - Oncology, Medical Affairs
  • SEC Life Sciences
  • One of the world's leading pharmaceutical companies is seeking four passionate, forward-thinking individuals for key rol...
  • 3/28/2024 12:00:00 AM

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Hospital Medical Leader
  • Petco
  • Menifee, CA
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 3/27/2024 12:00:00 AM

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Medication Management Associate
  • Fresenius Medical Care
  • Bluffton, IN
  • PURPOSE AND SCOPE: Promotes quality patient care, ongoing customer support and case management for Fresenius Medical Car...
  • 3/27/2024 12:00:00 AM

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Executive Director, Head of Medical Affairs, Immunology
  • RBW Consulting
  • Philadelphia, PA
  • A major international pharma business is looking to expands its immunology pipeline and requires a dynamic and forward t...
  • 3/25/2024 12:00:00 AM

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
$90,013 to $114,768

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