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)
Assistant Claims Risk Manager / Claims Risk Manager
San Bernardino, CA
Catholic Mutual Group (CMG) was established in 1889 and is recognized as the leading provider of property and casualty protection and related services for the Catholic Church in the United States and Canada.
Catholic Mutual Group has an excellent opportunity for an Assistant Claims Risk Manager (ACRM) or Claims Risk Manager (CRM) – depending upon experience - for our San Bernardino Service Office. The successful candidate will receive and adjust property/casualty claims by performing investigations/site inspections, evaluating liability, verifying coverages, and negotiating fair and equitable settlements. This person will also provide risk management services such as conducting annual safety inspections and establishing and monitoring risk management policies. Responsibilities will also include promoting safety awareness through educational seminars and online training and composing newsletters and other safety literature for distribution. Additional duties include general office administration and customer service. Frequent regional travel by automobile and an occasional overnight stay is required.
The individual in this position must have a good understanding of insurance with at least five years of experience in property and casualty claims adjusting. Prior risk management or safety experience is helpful. A four-year college degree and a good understanding of Catholic Church procedures and hierarchy is preferred. The candidate must also possess strong written and oral communication skills and be able to make independent, sound judgments and can work on multiple projects simultaneously. Good customer service skills are necessary. Must understand basic accounting procedures and can run an independent office without direct supervision. Must be willing to work irregular hours and be on call for emergencies and must have a valid driver’s license. Working knowledge of Microsoft Office and Outlook required.
Benefits include a competitive salary, paid holidays and generous vacation and sick accruals, a 403(b) plan with company match, paid life and AD&D insurance at five times the annual salary, long-term disability leave, paid job-related continuing education, and an excellent medical/vision/dental group insurance plan. The pay range for this position is $86,313 - $138,908 annually.
Qualified candidates may apply On-line
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