Medical Claims Review Manager jobs in Wisconsin

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 Manager
  • West Bend Insurance Company
  • West, WI FULL_TIME
  • Company Overview

    Recognized as a Milwaukee Journal Sentinel Top Workplace for 12 consecutive years, including three years of being honored as number one! Join us at West Bend, where we believe that our associates are our greatest asset. We hire talented individuals who are conscientious, dedicated, customer focused, and able to build lasting relationships. We create and maintain an environment where you feel a sense of belonging and appreciation. Your diversity of thought, experience, and knowledge are valued. We’re committed to fostering a welcoming culture, offering you opportunities for meaningful work and professional growth. More than a workplace, we celebrate our successes and take pride in serving our communities.

    Responsibilities & Qualifications

    Summary of Responsibilities

     

    Manage a team of senior level claim specialists and/or supporting technical staff. Claims processed are primarily third party claims on our personal lines and commercial lines of business but could include all lines of business.  Oversee the investigation and settlement of all claims, litigated and non-litigated assigned to the team. Provide advice and direction to claim representatives. Responsible for the selection, training, development and performance of personnel as well as performance reviews, salary adjustments and promotions. Handle special projects as assigned.

     

    Preferred Experience and Skills

    • 3- 5 years of prior supervision of claims personnel
    • 7 years of claims handling experience with at least 3 years of litigated file handling
    • Ability to lead, mentor and develop personnel.
    • Interpersonal skills
    • Oral and written communicational skills
    • Proficient in Word and Excel

     

    Preferred Education and Training

    • Bachelor’s degree in Business, Insurance or related field
    • Continuing insurance education
    • Insurance Designations: AIC, AIM, CPCU, SCLA

     

    #LI-BW1

     

    EEO

    West Bend provides equal employment opportunities to all associates and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, and promotion.

  • 10 Days Ago

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Medical Insurance Claims Specialist
  • Robert Half
  • Greendale, WI PER_DIEM
  • Robert Half is seeking a detail-oriented and highly organized individual to join our client's team as a Medical Insurance Claims Follow Up Specialist. In this role, you will be responsible for ensurin...
  • 5 Days Ago

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Medical Oncology Remote Chart Review Physicians
  • Max Populi, LLC
  • Milwaukee, WI FULL_TIME
  • 100% Remote opportunity to conduct utilization management - chart reviews for a brand name specialty benefits company. We are seeking several physicians with a board certification in Medical Oncology/...
  • 13 Days Ago

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Warranty Claims Manager
  • Dorsch Ford Lincoln Kia
  • Green, WI FULL_TIME
  • Job Title: Warranty Claims Manager Job Type: Full-time Salary: $55k-70k based on experience Hours: M-F 8am to 5pm Job Responsibilities: Submit warranty claims to proper manufacturer Grow team of admin...
  • 16 Days Ago

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Claims Manager - Risk Management
  • Milwaukee County Transit System
  • Milwaukee, WI FULL_TIME
  • JOB SUMMARY: Manage worker’s compensation, return-to-work and general liability claim programs for MCTS. Serve as liaison between MCTS and third-party administrators to ensure accurate, timely and eff...
  • 17 Days Ago

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Claims Analytics Manager
  • West Bend Insurance Company
  • West, WI FULL_TIME
  • Company Overview Recognized as a Milwaukee Journal Sentinel Top Workplace for 12 consecutive years, including three years of being honored as number one! Join us at West Bend, where we believe that ou...
  • 2 Days Ago

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Hospital Medical Leader
  • Petco
  • Baldwin, NY
  • Create a healthier, brighter future for pets, pet parents and people!If you want to make a real difference, create an ex...
  • 4/23/2024 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...
  • 4/22/2024 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 ...
  • 4/21/2024 12:00:00 AM

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Veterinarian - Hospital Medical Leader
  • Petco Animal Supplies Inc
  • Montclair, NJ
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 4/21/2024 12:00:00 AM

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Regional Medical Lead
  • HeartFlow, Inc
  • New York, NY
  • HeartFlow, Inc. is a medical technology company advancing the diagnosis and management of coronary artery disease, the #...
  • 4/21/2024 12:00:00 AM

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Regional Medical Lead
  • HeartFlow
  • New York, NY
  • HeartFlow, Inc. is a medical technology company advancing the diagnosis and management of coronary artery disease, the #...
  • 4/21/2024 12:00:00 AM

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US Pneumococcal Adult Medical Lead, MD
  • Pfizer
  • New York, NY
  • ROLE SUMMARY Provide pneumococcal franchise leadership on behalf of Asset Medical Affairs team. * Collaborates with Bran...
  • 4/21/2024 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 ...
  • 4/20/2024 12:00:00 AM

Wisconsin is bordered by the Montreal River; Lake Superior and Michigan to the north; by Lake Michigan to the east; by Illinois to the south; and by Iowa to the southwest and Minnesota to the northwest. A border dispute with Michigan was settled by two cases, both Wisconsin v. Michigan, in 1934 and 1935. The state's boundaries include the Mississippi River and St. Croix River in the west, and the Menominee River in the northeast. With its location between the Great Lakes and the Mississippi River, Wisconsin is home to a wide variety of geographical features. The state is divided into five dist...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$96,401 to $122,913

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