Medical Claims Review Manager Salary in United States

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Average Salary for Medical Claims Review Manager in United States

The average salary of a(n) Medical Claims Review Manager in United States is $94,569.

The average hourly rate of a(n) Medical Claims Review Manager in United States is $45.47.

The average bonus of a(n) Medical Claims Review Manager in United States is $5,239.00.

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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