Medical Claims Review Manager jobs in Oxnard, CA

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)

C
Medical Claims Processing
  • Community Memorial Healthcare
  • Ventura, CA OTHER
  • Compensation

    Salary Range: $18.36 - $27.67 / hour

     

    The pay range above represents the lowest possible rate for the position and the highest possible rate. Factors that may be used to determine where newly hired employees will be placed in the pay range include the employee specific skills and qualifications, relevant years of experience and comparison to other employees already in this role. Most often, a newly hired employee will be placed below the midpoint of the range. If you are viewing this posting on a job site, please visit our company page and search for the opportunity to view the pay range: https://careers-mycmh.icims.com/jobs

    Pay for PRN positions is calculated differently than Full-Time, Regular Part-Time, and Part-Time positions. PRN Rates depend on the position and other factors, including years of experience, or shift commitment according to the department policy. PRN differential is added in certain positions.

    Responsibilities

    Position Overview:

     

    Responsible for correcting all electronic 837 claims that have been flagged for various billing correction. Verify all claims transmissions to insurance companies for all billing systems and working all claims denials.

     

    Qualifications

    Required:  

    • High school diploma or general education degree (GED)
    • At least 1 year of Medical Claims Processing experience.

    Preferred: 

    • Associates degree in related field

    Overview

    When it comes to quality, we're 5 Star!

     

     

    Community Memorial Health System was established in 2005 when Community Memorial Hospital in Ventura merged with Ojai Valley Community Hospital. It is comprised of these two hospitals along with a network of primary and specialty care health centers serving various communities across west Ventura County. Our health system is a community-owned, not-for-profit organization. As such, we are not backed by a corporate or government entity, nor do we answer to shareholders. We depend on – and answer to – the communities we serve.

     

    Community Memorial Hospital – Ventura has been awarded a prestigious five-star rating by the Centers for Medicare & Medicaid Services (CMS)! This achievement represents thousands of people going the extra mile every day for our patients, and we are the ONLY hospital in Ventura County to earn this distinction!

     

     

    Community Memorial Healthcare Benefits

    To help heal, comfort, and promote health for the communities we serve, Community Memorial Healthcare takes care of our community of employees so our local community can be cared for. That’s why we provide competitive benefits, along with great career choices, training, and leadership development. Our total rewards package provides benefits that support you and your family’s health and wellness in all aspects of life. From our top tier insurance plans to our employee assistance program, take advantage of what CMH has to offer so you and your loved ones can have peace of mind now and for years to come. CMH is here for you and your family every step of the way.

     

    • Competitive Pay
    • Shift Differentials
    • In-House Registry Rates
    • Fidelity 403(b) Retirement Plan
    • Paid Time Off
    • Medical (EPO/PPO), Dental, & Vision Insurance Coverage
    • Voluntary Worksite Benefits
    • Employee Assistance Program Available 24/7 (EAP)
    • Tuition Reimbursement
    • Public Service Loan Forgiveness (PSLF)
    • Recognition programs
    • Employee service recognition events
    • Home, Retail, Travel & Entertainment Discounts
    • National Hospital Week and National Nurses Week celebrations

     

    Community Memorial Healthcare is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation. We strive to promote an environment where exceptional people bring diverse perspectives and find belonging, support and connection to their work in our community.

    “We are an AA/EEO/Veterans/Disabled Employer”

  • 10 Days Ago

S
Nurse Manager Medical/Surgical
  • St Johns Regional Medical Center
  • OXNARD, CA FULL_TIME
  • OverviewSt. John’s Regional Medical Center located in Oxnard California is a recognized as a Top 250 Hospital in the Nation and as one of America’s 100 Best Hospitals for Cardiac Care by Healthgrades....
  • 2 Days Ago

C
Sr. Marketing Manager Communications
  • Caldera Medical
  • Westlake, CA FULL_TIME
  • Sr. Manager Marketing CommunicationsWestlake Village, CA | On-Site Only – No remote optionCaldera Medical’s Mission - To Improve the Quality of Life for Women!Caldera Medical is a growth stage medical...
  • 12 Days Ago

A
Claims Analyst
  • ALKEME
  • Thousand Oaks, CA FULL_TIME
  • DescriptionPosition Summary:Looking for a detail-oriented, proactive individual with a passion for assisting clients and ensuring their peace of mind during challenging times. In this role, you will p...
  • 1 Month Ago

A
Medical Communications Manager
  • Advanced Bio-Logic Solutions Corp
  • Thousand Oaks, CA FULL_TIME
  • Description: Note: This position will be fully remote. No preference on time zone. Engagement worker will be working standard business hours. Hiring Managers preference with the type of academic backg...
  • 7 Days Ago

C
Medical Office Manager
  • Community Behavioral Health
  • Oxnard, CA FULL_TIME
  • Job Summary:Are you an inclusive, compassionate Office Manager looking for a rewarding role to put your exceptional skills to good? Our business is built on skilled, caring medical professionals dedic...
  • 10 Days Ago

Filters

Clear All

Filter Jobs By Location
  • Filter Jobs by companies
  • More

0 Medical Claims Review Manager jobs found in Oxnard, CA area

C
Hospice LVN Per Diem (1 year experience)
  • Cardinal Care Hospice Inc
  • Ventura, CA
  • Job Description Job Description Responsibilities of Per Diem LVN include but not limited to: Must have 1 year Hospice Ex...
  • 4/24/2024 12:00:00 AM

A
RN Case Manager - REMOTE
  • Actalent
  • Santa Barbara, CA
  • Non-profit healthcare network is looking for a registered nurse case manager to join their team on a contract basis! Opp...
  • 4/24/2024 12:00:00 AM

C
Nurse Practitioner or Physician Assistant
  • ConcertoCare
  • Ventura, CA
  • Apply Job Type Full-time Description The ConcertoCare Advanced Practice Provider (Nurse Practitioner and Physician Assis...
  • 4/24/2024 12:00:00 AM

A
Paramedic
  • Amr
  • Oxnard, CA
  • Job Description: Immediate Hiring for Gold Coast Oxnard, CA Starting annualized wage of $28.70/hour (12hr shift) Fast pa...
  • 4/24/2024 12:00:00 AM

H
Emergency Response Paramedic
  • Hiring Now!
  • Oxnard, CA
  • Job Description: Immediate Hiring for Gold Coast Oxnard, CA Starting annualized wage of $28.70/hour (12hr shift) Fast pa...
  • 4/24/2024 12:00:00 AM

S
Group Therapist
  • SBT
  • Camarillo, CA
  • Job Description Job Description Group Therapist- Mental Health and SUD Starting Pay: $60-100/hr Employment Type: Part-ti...
  • 4/23/2024 12:00:00 AM

L
Psychiatric Nurse Practitioner - Ventura, CA
  • LifeStance Health
  • Ventura, CA
  • At LifeStance Health, we believe in a truly healthy society where mental and physical healthcare are unified to make liv...
  • 4/21/2024 12:00:00 AM

A
Physician Assistant (PA-C) or Nurse Practitioner (NP), per diem
  • Ageless Mens Health
  • Oxnard, CA
  • Foster real relationships. Advance the cause of men's health. Improve lives. With over 70 clinics nationwide and a growi...
  • 4/21/2024 12:00:00 AM

Oxnard (/ˈɒksnɑːrd/) is a city in Ventura County, California, United States. Located along the coast of Southern California, it is the most populous city in Ventura County and the 19th most populous city in California. Incorporated in 1903, the city lies approximately 60 miles (97 km) west of downtown Los Angeles and is part of the larger Greater Los Angeles area. It is located at the western edge of the fertile Oxnard Plain, sitting adjacent to an agricultural center of strawberries and lima beans. Oxnard is also a major transportation hub in Southern California, with Amtrak, Union Pacific, ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$104,597 to $133,363
Oxnard, California area prices
were up 2.5% from a year ago

Medical Claims Review Manager in Paramus, NJ
Support management with leading Medical Review team to ensure all types of claims requiring medical reviews are completed in compliance with State, Federal, accreditation standards and other applicable regulations.
February 01, 2020
Medical Claims Review Manager in Nashua, NH
By truly combining claims and bill review, the two systems are kept in sync utilizing the scheduled jobs of the aforementioned standard model; however, for real-time data updates, claims examiners are granted access to the entire live bill review system.
January 13, 2020
Medical Claims Review Manager in Davenport, IA
Complex claim errors can only be caught by physician reviewers with the clinical experience to spot mistakes that automated systems can’t detect.
January 03, 2020