Medical Claims Review Manager jobs in Rialto, CA

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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Assistant Claims Risk Manager / Claims Risk Manager
  • Catholic Mutual Group
  • San Bernardino, CA FULL_TIME
  • 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

  • 4 Days Ago

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Mail Processor – Claims exp preferred -TEMPORARY
  • Choice Medical Group
  • Apple Valley, CA TEMPORARY
  • TEMPORARY JOB SUMMARY Responsible for sorting mail daily for CMG/CPN group UB-04 and CMS 1500. Make sure all claims are sorted by line of business, multiple dates, PDR, appeal, and retro authorization...
  • 26 Days Ago

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LVN Case Manager (Utinizatio Review) - Onsite In Redlands, Ca
  • Actalent
  • Redlands, CA OTHER
  • Description: As a part of the Utilization Management team the LVN Case Manager is a member of the Care Coordination team. LVN Case Manager have a queue of cases based on patient's last names. All new ...
  • 13 Days Ago

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Account Manager
  • RS Medical
  • San Bernardino, CA FULL_TIME
  • DescriptionRS Medical designs and builds prescription-grade medical devices that provide pain relief and muscle rehabilitation. Our DME products empower patients suffering from severe, often debilitat...
  • 1 Month Ago

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Account Manager
  • RS Medical
  • Redlands, CA FULL_TIME
  • DescriptionRS Medical designs and builds prescription-grade medical devices that provide pain relief and muscle rehabilitation. Our DME products empower patients suffering from severe, often debilitat...
  • 1 Month Ago

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Account Manager
  • RS Medical
  • Loma Linda, CA FULL_TIME
  • DescriptionRS Medical designs and builds prescription-grade medical devices that provide pain relief and muscle rehabilitation. Our DME products empower patients suffering from severe, often debilitat...
  • 1 Month Ago

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0 Medical Claims Review Manager jobs found in Rialto, CA area

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Psychiatrist - ANY state license - BONUS!
  • Valor Healthcare
  • Loma Linda, CA
  • Professional Summary: The contract psychiatry physician (s) shall provide clinical assessments, diagnoses, medication ma...
  • 4/19/2024 12:00:00 AM

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Remote Licensed Clinical Social Worker
  • Headway
  • San Bernardino, CA
  • Remote Licensed Clinical Social Worker (LCSW) Wage: Between $86-$130 an hour Are you a Licensed Clinical Social Worker l...
  • 4/16/2024 12:00:00 AM

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Remote Licensed Mental Health Counselor
  • Headway
  • San Bernardino, CA
  • Remote Licensed Mental Health Counselor (LMHC) Wage: Between $86-$130 an hour Are you a Licensed Mental Health Counselor...
  • 4/16/2024 12:00:00 AM

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Remote Licensed Psychiatrist
  • Headway
  • San Bernardino, CA
  • Remote Licensed Psychiatrist Wage: Between $148-$232 an hour Are you a licensed Psychiatrist looking to launch a private...
  • 4/16/2024 12:00:00 AM

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Remote Licensed Mental Health Therapist
  • Headway
  • San Bernardino, CA
  • Remote Licensed Mental Health Therapist (LMHT) Wage: Between $86-$130 an hour Are you a Licensed Mental Health Therapist...
  • 4/16/2024 12:00:00 AM

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Remote Licensed Psychiatric Nurse Practitioner
  • Headway
  • San Bernardino, CA
  • Remote Licensed Psychiatric Nurse Practitioner Wage: Between $144-$222 an hour Are you a licensed Psychiatric Nurse look...
  • 4/16/2024 12:00:00 AM

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Nurse Practitioner or Physician Assistant
  • ConcertoCare
  • San Bernardino, CA
  • Apply Job Type Full-time Description The ConcertoCare Advanced Practice Provider (Nurse Practitioner and Physician Assis...
  • 4/15/2024 12:00:00 AM

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Physician Clinic Medical Director
  • Concentra
  • Colton, CA
  • Overview: Looking for a Physician Leadership role in Colton, CA? Are you ready to take your career to new heights? At Co...
  • 4/15/2024 12:00:00 AM

Rialto is a city in San Bernardino County, California, United States. The population was 99,171 with the 2010 Census. Rialto is home to four major regional distribution centers: Staples Inc., which serves stores across the entire West Coast of the United States, Toys "R" Us, Under Armour and Target in the northern region of the city, in the Las Colinas community. One of the United States' largest fireworks companies, Pyro Spectaculars, is also headquartered in Rialto. Rialto is located at 34°6′41″N 117°22′57″W / 34.11139°N 117.38250°W / 34.11139; -117.38250 (34.111360, −117.382403). Accordi...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$103,036 to $131,372
Rialto, California area prices
were up 3.0% from a year ago

Medical Claims Review Manager in Paramus, NJ
Support management with leading Medical Review team to ensure all types of claims requiring medical reviews are completed in compliance with State, Federal, accreditation standards and other applicable regulations.
February 01, 2020
Medical Claims Review Manager in Nashua, NH
By truly combining claims and bill review, the two systems are kept in sync utilizing the scheduled jobs of the aforementioned standard model; however, for real-time data updates, claims examiners are granted access to the entire live bill review system.
January 13, 2020
Medical Claims Review Manager in Davenport, IA
Complex claim errors can only be caught by physician reviewers with the clinical experience to spot mistakes that automated systems can’t detect.
January 03, 2020