Medical Claims Review Manager jobs in Virginia

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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Medical Review Manager (Full-time, Remote)
  • Integrity Management Services, Inc.
  • Alexandria, VA FULL_TIME
  • About Us

    Integrity Management Services, Inc. (IntegrityM) is an award-winning, women-owned small business specializing in assisting government and commercial clients in compliance and program integrity efforts, including the prevention and detection of fraud, waste and abuse in government programs. Results are achieved through data analytics, technology solutions, audit, investigation, and medical review.

    At IntegrityM, we offer a culture of opportunity, recognition, collaboration, compassion and supporting our community. We thrive off of these fundamental elements that make IntegrityM a great place to work. Our small, flexible workplace offers an exceptional quality of life and promotes corporate-driven sustainability. We deliver creative solutions that exceed goals and foster a dynamic, idea-driven environment that nurtures our employees’ professional development. Large company perks…Small company feel!

    We are now seeking a Medical Review Manager to join our team. This is a contingent position.

    • Minimum three (3) years’ experience practicing nursing as a licensed Registered Nurse
    • Minimum of three (3) years’ experience of supervisory/managerial experience in the health insurance industry
    • Bachelor’s degree in Nursing is required.
    • Registered Nurse Licensure
    • Certified Professional Coder (CPC) Certification or the ability to obtain this certification or similar coding certification within 12 months of appointment
  • 4 Days Ago

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Medical Insurance Biller Claims Representative
  • Medical Temporaries, Inc.
  • Chesapeake, VA FULL_TIME
  • Job Description: Medical Temporaries, Inc. is currently seeking an experienced Medical Insurance Biller. Minimum of 1 year of experience required in medical billing. This is a FULL TIMEposition requir...
  • Just Posted

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Review Project Manager
  • Innovative Discovery LLC
  • Arlington, VA FULL_TIME
  • Innovative Discovery is seeking an experienced Review Project Manager in its DC metro area offices to provide management and execution of managed review projects for a broad spectrum of ID’s clients, ...
  • 1 Month Ago

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Sr. Review Project Manager
  • Innovative Discovery LLC
  • Arlington, VA FULL_TIME
  • Innovative Discovery is seeking an experienced Senior Review Project Manager in its DC metro area offices to provide management, oversight, and execution of multiple eDiscovery projects for a broad sp...
  • 1 Month Ago

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Manager, Claims
  • AZGROUPPROD
  • Richmond, VA FULL_TIME
  • The Manager, Claims oversees the operations and performance of or claims department. Is responsible for developing and implementing strategies that align with the company's overall goals and objective...
  • 7 Days Ago

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Medical Insurance Claims Specialist
  • Robert Half
  • Hampton, VA FULL_TIME
  • Job Description Job Description If you're an experienced Denials Specialist who has worked within the healthcare field, there's a terrific opportunity through Robert Half for you to consider. We've pa...
  • Just Posted

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Head of Medical Writing
  • Morgan Prestwich - Life Science & Healthcare Executive Search
  • Company Overview Morgan Prestwich is thrilled to be representing our client on an exclusive basis. Our client is a clini...
  • 3/29/2024 12:00:00 AM

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Hospital Medical Leader
  • Petco Animal Supplies Inc
  • Orem, UT
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 3/28/2024 12:00:00 AM

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Hospital Medical Leader
  • Petco Animal Supplies Inc
  • Fairfield, CA
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 3/28/2024 12:00:00 AM

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Hospital Medical Leader
  • Petco Animal Supplies Inc
  • Folsom, CA
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 3/28/2024 12:00:00 AM

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Medical Lead - Oncology, Medical Affairs
  • SEC Life Sciences
  • One of the world's leading pharmaceutical companies is seeking four passionate, forward-thinking individuals for key rol...
  • 3/28/2024 12:00:00 AM

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Hospital Medical Leader
  • Petco
  • Menifee, CA
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 3/27/2024 12:00:00 AM

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Medication Management Associate
  • Fresenius Medical Care
  • Bluffton, IN
  • PURPOSE AND SCOPE: Promotes quality patient care, ongoing customer support and case management for Fresenius Medical Car...
  • 3/27/2024 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...
  • 3/25/2024 12:00:00 AM

Virginia (/vərˈdʒɪniə/ (listen)), officially the Commonwealth of Virginia, is a state in the Southeastern and Mid-Atlantic regions of the United States located between the Atlantic Coast and the Appalachian Mountains. Virginia is nicknamed the "Old Dominion" due to its status as the first English colonial possession established in mainland North America and "Mother of Presidents" because eight U.S. presidents were born there, more than any other state. The geography and climate of the Commonwealth are shaped by the Blue Ridge Mountains and the Chesapeake Bay, which provide habitat for much of ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$96,768 to $123,381

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