Medical Claims Review Manager jobs in Texas

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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Claims Service Manager / Auto
  • Allcat Claims Service, LLC
  • US TX Remote, TX FULL_TIME
  • ABOUT ALLCAT CLAIMS SERVICE Allcat Claims Service is an energetic company that places a high emphasis on learning and personal development by supporting and challenging its people to reach their full potential. As a result, Allcat Claims Service places a premium on customer service, quality, and rapid integration of emerging technology. Most importantly, we pride ourselves on handling claims both professionally and ethically. Our commitment to “Raising the Bar” has allowed us to grow our client and adjuster relationships over the years into something special. The experience of our team and their work ethic is unparalleled in the claims industry. DESCRIPTION: This position is in our San Antonio office and leads a team of auto claims service professionals to deliver outstanding customer service and business results. JOB RESPONSIBILITIES: Leads their team to achieve goals and objectives by communicating job expectations; planning, monitoring, and appraising job results; coaching, counseling, and disciplining employees; developing, coordinating, and enforcing systems, policies, procedures, and productivity standards. Maintains staff by recruiting, selecting, orienting, and training employees; manage employee work schedules including assignments, training, vacations, and paid time off, overtime and ensuring coverage for absenteeism. Contributes to the creation of strategic goals by gathering pertinent business, financial, service, and operations information; identifying and evaluating trends and options; choosing a course of action; defining objectives; evaluating outcomes. Maintains quality service by enforcing quality and customer service standards; analyzing and resolving quality and customer service problems; identifying trends; recommending process improvements. Appropriately communicates information through department meetings, one-on-one meetings, and appropriate email, IM, and regular interpersonal communication. Develops critical skillsets of their team as well as assisting their team with career development goals. Handles escalations, DOI complaints and claims with attorney representation. Contributes to business goals, performance metrics, and effectively uses tools & technology. Supports workload surges and/or catastrophe operations as needed to include working overtime during designated catastrophe events. MINIMUM REQUIREMENTS: Bachelor's degree or equivalent work experience. 5 years auto claims experience Strong analytical and problem-solving skills. Strong customer service skills. Demonstrated knowledge of Microsoft Office products. Must be a team-oriented individual to work with clients, other team members, and internal partners. Availability to work after hours and at the weekend as needed. Excellent verbal and written communication skills. Current TX adjuster license or ability to obtain TX adjuster license (paid by Allcat). Enjoys working in a fast-paced environment and easily acclimates to changes in process/systems for overall improvement of the organization. Ability to learn new technologies. PREFERRED REQUIREMENTS: Prior experience leading Injury claim professionals. A minimum of 2 years’ experience handling and managing moderate, severe, and complex injury claims including fatalities and catastrophic injuries Experience managing complex coverage claims Multi state claim licenses a plus CA claim handling a plus Bachelor’s degree Prior military service Prior customer service experience. Medical, Dental & Vision plans BENEFITS: Eligibility to participate in Comprehensive Benefits Package: Medical, Dental and Vision, Paid Time Off and Paid Holidays, in accordance with Company policy. Why work for Allcat? HSA & FSA Life Insurance 401k with up to a 4% match Annual onsite flu & vaccination clinic Paid Time Off & Paid Holidays Referral Bonus Program Jean Day everyday Free Parking Game room/lounge area Onsite micro market (snacks & beverages) Food trucks bi-weekly Complimentary Coffee Bar Company Town Hall Meetings & Celebrations Annual Performance Reviews Frequent Performance Feedback Career Growth Opportunities Wounded Warrior & Military Focus “On Fridays We Wear RED” Diversity, Equity, and Inclusion Program Job Type: Full-time Salary: $66,000.00 - $99,000.00 per year Allcat Claims Service, LP is a total solution provider for all of your insurance claims needs. We can handle all aspects of your claims process, including initial calls received during normal business hours; as well as weekends, after hours and emergency call centers. We can also handle the estimating, closing and issuing of checks for the claim as well as issuing depreciation holdback and indemnity checks. With our real-time electronic reporting and tracking of claims, you will always be able to have the most updated information for your organization to make the most informed decisions. We have the knowledge and the team in place to make your claims department the best that it can be.
  • 4 Days Ago

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Medical Only Adjuster
  • TheBest Claims Solutions
  • Austin, TX OTHER
  • Medical Only Adjuster AUSTIN, TX 78701 | DIRECT HIRE $20.00 TO $25.00 PER HOUR, DEPENDING ON EXPERIENCE Job Description Our client, a National Insurance Company, is looking for a Worker's Compensation...
  • 12 Days Ago

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Medical Only Adjuster
  • TheBest Claims Solutions
  • Dallas, TX OTHER
  • Medical Only Adjuster DALLAS, TX 75201 | DIRECT HIRE $20.00 TO $25.00 PER HOUR, DEPENDING ON EXPERIENCE Job Description Our client, a National Insurance Company, is looking for a Worker's Compensation...
  • 12 Days Ago

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Medical Only Adjuster
  • TheBest Claims Solutions
  • Houston, TX OTHER
  • Medical Only Adjuster HOUSTON, TX 77040 | DIRECT HIRE $20.00 TO $25.00 PER HOUR, DEPENDING ON EXPERIENCE Job Description Our client, a National Insurance Company, is looking for a Worker's Compensatio...
  • 12 Days Ago

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Medical Only Adjuster
  • TheBest Claims Solutions
  • San Antonio, TX OTHER
  • Medical Only Adjuster SAN ANTONIO, TX 78015 | DIRECT HIRE $20.00 TO $25.00 PER HOUR, DEPENDING ON EXPERIENCE Job Description Our client, a National Insurance Company, is looking for a Worker's Compens...
  • 12 Days Ago

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Claims Review Specialist
  • Sound Physicians
  • Plano, TX FULL_TIME
  • About Sound: Headquartered in Tacoma, WA, Sound Physicians is a physician-founded and led, national, multi-specialty medical group made up of more than 1,000 business colleagues and 4,000 physicians, ...
  • 14 Days Ago

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Senior Research Nurse - Thoracic Head & Neck Medical Oncology
  • MD Anderson
  • Houston, TX
  • The University of Texas MD Anderson Cancer Center is ranked the nation's top hospital for cancer care by U.S. News & Wor...
  • 4/18/2024 12:00:00 AM

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Technologist-Medical Lead - MG Diagnostic Lab BMG
  • Baptist Memorial
  • Germantown, TN
  • Summary Perform all functions of the Medical Technologist and supervise the personnel and activities of various sections...
  • 4/18/2024 12:00:00 AM

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Head of Medical Writing
  • Proclinical Staffing
  • Head of Medical Writing - Permanent - Onsite Proclinical is seeking a Head of Medical Writing to join a cutting-edge bio...
  • 4/17/2024 12:00:00 AM

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Head of Medical Writing
  • Aerovate Therapeutics Inc.
  • Waltham, MA
  • Aerovate (AVTE) is a clinical stage biopharmaceutical company focused on developing drugs that meaningfully improve the ...
  • 4/16/2024 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...
  • 4/16/2024 12:00:00 AM

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Head of Medical Writing
  • Aerovate Therapeutics, Inc.
  • Waltham, MA
  • Aerovate (AVTE) is a clinical stage biopharmaceutical company focused on developing drugs that meaningfully improve the ...
  • 4/15/2024 12:00:00 AM

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Senior Director, Global Pharmacovigilance & Risk Management Head of Medical Safety
  • Vir Biotechnology, Inc.
  • Vir Biotechnology, Inc. is an immunology company focused on combining cutting-edge technologies to treat and prevent inf...
  • 4/15/2024 12:00:00 AM

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Regional Medical Lead - West
  • HeartFlow
  • Dallas, TX
  • HeartFlow, Inc. is a medical technology company advancing the diagnosis and management of coronary artery disease, the #...
  • 4/14/2024 12:00:00 AM

Texas (/ˈtɛksəs/, locally /ˈtɛksɪz/; Spanish: Texas or Tejas Spanish pronunciation: [ˈtexas] (listen)) is the second largest state in the United States by both area and population. Geographically located in the South Central region of the country, Texas shares borders with the U.S. states of Louisiana to the east, Arkansas to the northeast, Oklahoma to the north, New Mexico to the west, and the Mexican states of Chihuahua, Coahuila, Nuevo León, and Tamaulipas to the southwest, while the Gulf of Mexico is to the southeast. Houston is the most populous city in Texas and the fourth largest in the...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$95,523 to $121,793

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