Medical Claims Review Manager jobs in Simi Valley, 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”

  • 2 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....
  • 22 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...
  • 4 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

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...
  • 2 Days Ago

A
Medical Writing Manager
  • Amgen
  • Thousand Oaks, CA FULL_TIME
  • HOW MIGHT YOU DEFY IMAGINATION?You’ve worked hard to become the professional you are today and are now ready to take the next step in your career. How will you put your skills, experience and passion ...
  • 26 Days Ago

Filters

Clear All

Filter Jobs By Location
  • Filter Jobs by companies
  • More

0 Medical Claims Review Manager jobs found in Simi Valley, CA area

H
Remote Licensed Clinical Social Worker
  • Headway
  • Thousand Oaks, CA
  • Remote Licensed Clinical Social Worker (LCSW) Wage: Between $86-$130 an hour Are you a Licensed Clinical Social Worker l...
  • 4/16/2024 12:00:00 AM

H
Remote Licensed Psychiatrist
  • Headway
  • Thousand Oaks, CA
  • Remote Licensed Psychiatrist Wage: Between $148-$232 an hour Are you a licensed Psychiatrist looking to launch a private...
  • 4/16/2024 12:00:00 AM

H
Remote Licensed Mental Health Counselor
  • Headway
  • Thousand Oaks, CA
  • Remote Licensed Mental Health Counselor (LMHC) Wage: Between $86-$130 an hour Are you a Licensed Mental Health Counselor...
  • 4/16/2024 12:00:00 AM

H
Licensed Vocational Nurse (LVN) Med Surg - Part Time, Nights (Los Angeles)
  • Hiring Now!
  • Chatsworth, CA
  • The Licensed Vocational Nurse performs a wide variety of patient care activities under the direction of registered nursi...
  • 4/16/2024 12:00:00 AM

H
Licensed Vocational Nurse (LVN) Med Surg - Loan Forgiveness & $7,000 Sign-on Bonus - Full Time, Nights (Los Angeles)
  • Hiring Now!
  • Chatsworth, CA
  • The Licensed Vocational Nurse performs a wide variety of patient care activities under the direction of registered nursi...
  • 4/15/2024 12:00:00 AM

H
Licensed Vocational Nurse (Med/Surg) - Loan Forgiveness & $7,000 Sign-on Bonus - Full Time, Nights (LACH)
  • Hiring Now!
  • Chatsworth, CA
  • The Licensed Vocational Nurse performs a wide variety of patient care activities under the direction of registered nursi...
  • 4/15/2024 12:00:00 AM

C
Front/Back Office Assistant
  • Candy Medical Management
  • Hermosa Beach, CA
  • Job Description Job Description Pier Medical Aesthetics/ Candy Medical Mgmt is hiring a part-time to grow to full-time f...
  • 4/14/2024 12:00:00 AM

I
Medical Director, Medical Management
  • Imperial Health Plan of California, Inc.
  • Pasadena, CA
  • People are the most important asset of Imperial, for this reason the difference and plurality of people, equality of opp...
  • 4/13/2024 12:00:00 AM

Simi Valley is a city located in the very southeast corner of Ventura County, bordering the San Fernando Valley in Los Angeles County, and is a part of the Greater Los Angeles Area. The City of Simi Valley basically consists of the eponymous valley itself. City of Simi Valley borders the Santa Susana Mountains to the north, the Simi Hills to the east and south, and is adjacent to Thousand Oaks to the southwest and Moorpark to the west. Simi Valley is connected to the nearby San Fernando Valley by the Santa Susana Pass in the extreme east of Simi Valley. Simi Valley is located at 34°16'16" Nort...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$106,158 to $135,353
Simi Valley, 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