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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This opportunity is in the Claims Department.
Our Claims department oversees both high-exposure workers’ compensation and liability claims. As an unbundled carrier, we work actively with third-party administrators (TPAs) and self-administered accounts to assist in guiding claims to a successful resolution. As an excess carrier, the catastrophic claims we handle keep our group challenged, but the uniqueness provides plenty of growth opportunities.
Role Description:
In the role of Claims Process Optimization Manager you will be responsible for optimizing Liability claim processes focused on improving operational efficiencies, quality and service by analyzing existing workflows, identifying areas of improvement, establishing role clarity and implementing changes through collaborative work and within a defined decision-making process.
Your day-to-day responsibilities as a Claims Process Optimization Manager will include:
The ideal candidate is someone who has:
Qualifications:
Education:
Required:
Preferred:
If this role describes you, apply today!
Safety National is a leading specialty insurance and reinsurance provider. Our culture is built upon relationships, which allow us to demonstrate our expertise gained through our rich 80-year history. As a wholly-owned subsidiary of Tokio Marine, Inc., we appreciate the benefits and support provided by our affiliation with one of the top 10 insurance companies in the world.
A Benefits Structure That Puts Employees First
Safety National’s approach to benefits reaches far beyond competitive fixed compensation. Instead, we construct a total rewards benefits package for each valued member of our team. Highlights include incentive award bonuses, an annual holiday bonus, and profit-sharing contributions. Other exceptional benefits include generous healthcare coverage, a 401(k) match, enhanced paid caregiver leave, and family-forming benefits for adoption, surrogacy, and fertility. We also promote balance by offering a hybrid working environment and several employee appreciation events throughout the year. Apply today to learn more about our total rewards approach.