Medical Claims Review Manager jobs in the United States

MMRO's Healthcare Review Specialist is responsible for the lifecycle of healthcare claims; including but not limited to, receiving the initial request, reviewing the case for service type and conflict of interest, confirming the appropriate paperwork, creating the report template for the Physician, referring for a medical appointment, calling claimants to get information and/or to give the determination/claim outcome.

Experience that will help you excel in this role: organization, detail oriented, familiarity with medical terminology, scheduling medical appointments, customer service experience and medical office experience.

If you have industry knowledge of healthcare claims, workers comp, short term disability, long term disability or RX claims, that is beneficial.

MMRO seeks new team members who are reliable, punctual, detail oriented, respectful and contribute to a positive workplace culture.

This position works 8am to 4pm EST in our Novi office and rotates on-call weekends for urgent cases. The average weekend work required if on call is up to 5 hours total

Job Type: Full-time

Pay: $42,500.00 - $45,500.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Work setting:

• In-person
• Office

Experience:

• Microsoft Office: 1 year (Preferred)
• Customer service: 1 year (Preferred)

Ability to Commute:

• Novi, MI 48377 (Preferred)

Ability to Relocate:

• Novi, MI 48377: Relocate before starting work (Required)

Work Location: In person