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Medical Claims Review Manager Job Description
The following is a full job description for Medical Claims Review Manager. Here are the requirements and responsibilities for Medical Claims Review Manager along with statistics. If after reading this page you determine that Medical Claims Review Manager is not the position you are looking for, you may want to try one of these similar titles: Claims Manager, Senior, Claims Manager, Claims Examiner II, Claims Examiner III, Claims Examiner I, Claims Examiner IV, VP of Claims, Medical Policy Manager, Claims Supervisor II
Requirements and Responsibilities For 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. Evaluates medical claims review processes and recommends process improvements. Serves as a technical resource for all medical review workers. Typically requires an RN or BSN. Requires a bachelor's degree. Typically reports to a head of a unit/department. 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. Typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required.
 
Also referred to as: Medical Claims Quality Nurse Manager
Similar Jobs:  Claims Manager, Senior, Claims Manager, Claims Examiner II, Claims Examiner III, Claims Examiner I, Claims Examiner IV, VP of Claims, Medical Policy Manager, Claims Supervisor II
Level of Education:  Medical Claims Review Manager Salaries with a Bachelor's Degree, Medical Claims Review Manager Salaries with a Master's Degree or MBA, Medical Claims Review Manager Salaries with a JD, MD, PhD or Equivalent
Industries:  Edu., Gov't. & Nonprofit, Healthcare, Insurance
Job Statistics
Years of Experience Education Level
0-12-55-1010-1515+
No diplomaHigh SchoolAssociate's/CertificateBachelor'sMaster'sDoctorate
Company Size Industry
<100100-500500-10001000-75007500-15,00015K-50k50k+0%10%20%30%40%50%60%70%
HealthcareInsuranceEdu., Gov't. & Nonprofit0%20%40%60%80%100%
Most Popular Cities for Medical Claims Review Manager