Medical Claims Review Manager Salary in Cleveland, Ohio

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Average Salary for Medical Claims Review Manager in Cleveland, Ohio

The average salary of a(n) Medical Claims Review Manager in Cleveland, Ohio is $93,902.

The average hourly rate of a(n) Medical Claims Review Manager in Cleveland, Ohio is $45.15.

The average bonus of a(n) Medical Claims Review Manager in Cleveland, Ohio is $5,202.00.

Job Description:

Manages the medical claims review staff to ensure process improvement and quality in claims review. Interfaces with clients to conduct/manage random sample reviews to determine medical claims processing accuracy and timeliness. Communicates with clients to coordinate operational reviews to assess administrative processes and controls. Translates benefit plan language (Summary Plan Descriptions) into standard review program procedures. Reviews organization's claims, eligibility, provider, and medical management systems to identify issues affecting quality and productivity. Documents findings and writes follow-up reports. Provides planning, organizing, and budgeting for the department. Develops, administers, and reports service quality indicators for each team under supervision. Recommends and implements innovative strategies to retain members, contain medical costs, and improve efficiency. Hires, trains, coaches, counsels, and evaluates performance of direct reports. Less

Manages the medical claims review staff to ensure process improvement and quality in claims review. Interfaces with clients to conduct/manage random sample reviews to determine medical claims processing accuracy and timeliness. Communicates with clients to coordinate operational reviews to assess... More

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Results for Medical Claims Review Manager in Cleveland, Ohio

Manager, Patient Accounts - Highland Hills, OH

University Hospitals

Analyzes and resolves claims; Acts as primary contact for outside discount agencies working on behalf of commercial carriers looking for reductions on UH Claims...

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Revenue Cycle Manager - Cleveland, OH

Community Care Ambulance Network

Analyzes claims, utilization, and medical cost data. Revenue Cycle Manager. Monitor and Review Government Payors (Medicare/Medicaid)....

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Provider Contracting Sr. Specialist - Independence, OH

Cigna

Initiates and maintains effective channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management....

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Behavioral Health Clinical Care Manager - Strongsville, OH

Medical Mutual of Ohio

As necessary, will provide assistance to Claims and/or Customer Care Departments with the definition of medical terms, including diagnosis and procedures, as...

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Coding Reimbursement Coordinator - Garfield Heights, OH

Marymount Hospital

MEDICAL STAFF APPROVAL:. Formal coursework in anatomy, physiology and medical terminology in order to accurately interpret the medical record....

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