Medical Claims Review Manager jobs in Rialto, 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
Mail Processor – Claims exp preferred -TEMPORARY
  • Choice Medical Group
  • Apple Valley, CA TEMPORARY
  • TEMPORARY

    JOB SUMMARY
    Responsible for sorting mail daily for CMG/CPN group UB-04 and CMS 1500. Make sure all claims are sorted by line of business, multiple dates, PDR, appeal, and retro authorizations. Make sure that the Out of Area claims are identified and forwarded according to regulations.

    QUALIFICATIONS
    ·         High School Diploma or Equivalent

    ·         Claims experience, Healthcare experience required

    ·         Requires an ability to communicate well, multitask and stay organized

    ·         Knowledge of Microsoft (Word, Excel, PowerPoint)

    ·         Strong computer and data entry skills

     

    SKILLS
    ·         Must have effective communication, facilitation, interpersonal and professional diplomacy skills.

    ·         Strong attention to detail with ability to manage multiple priorities while meeting deadlines.

    ·         Able to Problem-solve, negotiate and demonstrate independent decision-making.

    ·         Strong communication skills in both oral and written form.

    ·         Positive attitude and takes a team approach to management.

    ·         Maintain strong skills in diplomacy, professionalism and trustworthiness.

    ·         Familiarity with Microsoft applications, which include the ability to learn new computer systems and applications.

    ·         Ability to manage multiple priorities and projects.

    ·         Detail oriented with desire for producing work with 100% accuracy.

    ·         Excellent analytical and problem-solving skills.

    Pay: $17/hr – $22.10/hr DOE

    As an Equal opportunity employer, DBA Choice Medical Group is committed to a diverse workforce.  Employment decisions regarding recruitment and selection will be made without discrimination based on race, color, religion, national origin gender, age sexual orientation, physical or mental disability, genetic information or characteristic, gender identity, and expression,  veteran status, or other non-job related characteristics or other prohibited grounds specified in applicable federal, state and local laws.  In order to ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Era Veterans’ Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact this post for assistance.

     

    For more information about equal employment opportunity protections, please view the ‘EEO is the Law’ poster.

    NOTICE: EMPLOYEE POLYGRAPH PROTECTION ACT
    YOUR RIGHTS UNDER THE FAMILY AND MEDICAL LEAVE ACT

    PAY TRANSPARENCY NONDISCRIMINATION PROVISION

     

    Our environment respects individual differences and recognizes each employee as an integral member of our company. Our workforce reflects these values and celebrates the individuals who make up our growing team.

    Choice Medical Group provides a work environment free of harassment and prohibited conduct. We promote and support individual differences and diversity of thoughts and opinion.

  • 1 Month Ago

R
Account Manager
  • RS Medical
  • San Bernardino, CA FULL_TIME
  • DescriptionRS Medical designs and builds prescription-grade medical devices that provide pain relief and muscle rehabilitation. Our DME products empower patients suffering from severe, often debilitat...
  • 1 Month Ago

R
Account Manager
  • RS Medical
  • Redlands, CA FULL_TIME
  • DescriptionRS Medical designs and builds prescription-grade medical devices that provide pain relief and muscle rehabilitation. Our DME products empower patients suffering from severe, often debilitat...
  • 1 Month Ago

A
Utilization Review RN
  • Actalent
  • San Bernardino, CA OTHER
  • Description: As a part of the Utilization Management team the Utilization Review RN is a member of the Care Coordination team. The goal of care coordination is to assist in managing care, cost, and ou...
  • 4 Days Ago

O
Travel Registered Nurse RN Case Manager
  • OneStaff Medical
  • APPLE VALLEY, CA FULL_TIME
  • We. Are. OneStaff. Medical. An independently - owned, nationally - recognized and amazingly awesome staffing firm ready to work for you! A work ethic forged in the Midwest, we are here to stand by you...
  • 1 Month Ago

S
Claims Assistant
  • San Bernardino County
  • San Bernardino, CA FULL_TIME
  • The Department of Risk Management is recruiting for Claims Assistants who assist Workers' Compensation Adjusters with routine aspects of complex cases. Duties include the following: obtain and documen...
  • 4 Days Ago

Filters

Clear All

Filter Jobs By Location
  • Filter Jobs by companies
  • More

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

J
HIRING PER DIEM RN/LVN/Certified Home Health Aid
  • Jameco Home Health Agency Inc.
  • Upland, CA
  • Job Description Job Description Benefits/Perks Flexible Scheduling Competitive Compensation Careers Advancement RN- $120...
  • 4/25/2024 12:00:00 AM

P
Psychiatrist - Loma Linda CA
  • Posterity Group, LLC
  • Loma Linda, CA
  • Job Description Job Description An excellent opportunity exists to work for a government contractor with competitive com...
  • 4/25/2024 12:00:00 AM

S
Claims Adjuster - Workers Compensation
  • Sedgwick
  • Rancho Cucamonga, CA
  • **Claims Adjuster - Workers Compensation** **Claims Adjuster - Workers Compensation** **The 'Apply with SEEK' option wil...
  • 4/24/2024 12:00:00 AM

P
Sales District Leader Designate- Bloomington, California
  • PepsiCo
  • Rialto, CA
  • Overview We are PepsiCo Sales. We are game changers, mountain movers and history makers. We are a diverse group, spread ...
  • 4/24/2024 12:00:00 AM

U
CDL-A OTR Team Drivers - Top Team Pay + Great Benefits
  • U.S. Xpress
  • Rialto, CA
  • U.S. Xpress is Now Hiring CDL-A OTR Team Drivers! CDL-A Teams: Top Team Pay in the Nation & Up To $15,000 Sign-On Bonus/...
  • 4/24/2024 12:00:00 AM

U
Sales Associate
  • United Pacific
  • Rialto, CA
  • As a Sales Associate you will be eligible for; * 401K * Tuition Reimbursement Program * Flexible schedules Full Time pos...
  • 4/24/2024 12:00:00 AM

C
CA Licensed Collaborative Care Clinician - Bilingual
  • Concert Health
  • Fontana, CA
  • Concert Health is Hiring! Concert Health’s Collaborative Care Model allows individuals to receive the care they need whi...
  • 4/21/2024 12:00:00 AM

V
Psychiatrist - ANY state license - BONUS!
  • Valor Healthcare
  • Loma Linda, CA
  • Professional Summary: The contract psychiatry physician (s) shall provide clinical assessments, diagnoses, medication ma...
  • 4/21/2024 12:00:00 AM

Rialto is a city in San Bernardino County, California, United States. The population was 99,171 with the 2010 Census. Rialto is home to four major regional distribution centers: Staples Inc., which serves stores across the entire West Coast of the United States, Toys "R" Us, Under Armour and Target in the northern region of the city, in the Las Colinas community. One of the United States' largest fireworks companies, Pyro Spectaculars, is also headquartered in Rialto. Rialto is located at 34°6′41″N 117°22′57″W / 34.11139°N 117.38250°W / 34.11139; -117.38250 (34.111360, −117.382403). Accordi...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$103,036 to $131,372
Rialto, California area prices
were up 3.0% 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