Medical Claims Review Manager jobs in Rhode Island

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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RI - 1099 Property Claims Adjuster
  • Copper Claims Services, Inc.
  • Providence, RI FULL_TIME
  • 1099 Property Claims Adjuster

    Copper Claims Services is a quickly growing independent loss adjusting firm based out of Irvine, CA.

    Copper Claims Services excels in providing custom claims solutions for Property and Casualty, Transportation and High Net Worth, with an emphasis on Specialized Programs.

    We are currently looking for licensed adjusters (or individuals who will obtain their license upon onboarding) to assist with daily claims handling for the Rhode Island area. In this role, you will manage, investigate and resolve homeowner and commercial property losses of moderate to severe complexity with minimal supervision to include completing field investigations, evaluating and analyzing coverage, completing property damage estimates, reporting findings to various clients, and handling files to the conclusion of the claim.

    In this role, you will:

    • Handle claims during local catastrophes
    • Complete field investigations including inspections, interviews, preparing diagrams, taking photographs, and various other tasks
    • Analyze insurance coverage issues on specific claims and make appropriate recommendations to our clients
    • Prepare detailed estimates in Xactimate based on our client’s specifications and parameters
    • Prepare clear, concise, and timely narrative reports for our clients
    • Create ITV reports
    • Evaluate co-insurance calculations and penalties if applicable
    • Maintain continuous and professional communication with our clients to ensure their needs are being met.
    • Analyze and evaluate damages including reserves, property estimates, business personal property inventories, business interruption, and business income losses
    • Investigate, analyze, adjust and negotiate settlements with insured’s in compliance with our client’s direction
    • Coordinate and oversee vendors such as emergency service contractors, origin and cause investigators, general contractors, engineers, etc.

    Qualifications:

    • 5 years of field Property adjusting experience
    • Ability to climb ladders/Access roofs
    • Thorough knowledge and understanding of roofing, HVAC, and various other mechanical specialties
    • Knowledge of Commercial Lines insurance policies
    • Proficient in Xactimate including Sketch
    • Previous experience with Xactanalysis preferred
    • Proficient in Microsoft Office (Word, Excel, and Outlook)
    • Effective negotiation skills
    • Ability to effectively and independently manage workload
    • Proven ability to provide exceptional customer service
    • Strong written and verbal communication skills
    • Exceptional organization and time management skills

    Job Type: Full-time

    Pay: $30.00 - $35.00 per hour

    Schedule:

    • 8 hour shift
    • Monday to Friday

    Work setting:

    • Outdoor work

    Work Location: On the road

  • 15 Days Ago

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Field Roof Technician
  • Hancock Claims Consultants
  • Providence, RI CONTRACTOR
  • CLIMB to New Heights…And live the American Dream. Become part of something bigger by contracting with the nation’s top provider of roof and property inspection services working with insurance carriers...
  • Just Posted

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Field Roof Technician
  • Hancock Claims Consultants Technicians
  • Providence, RI CONTRACTOR
  • CLIMB to New Heights…And live the American Dream. Become part of something bigger by contracting with the nation’s top provider of roof and property inspection services working with insurance carriers...
  • 24 Days Ago

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Credit review
  • Bank of America
  • Providence, RI FULL_TIME
  • Description Through examinations and monitoring, Credit Review provides an independent assessment of credit decisions and the effectiveness of credit processes across the bank’s credit platform, ident...
  • 20 Days Ago

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Utilization review specialist
  • Virgin Pulse
  • Providence, RI FULL_TIME
  • Utilization Review Intake Specialist HealthComp Remote, United States Now is the time to join us! Virgin Pulse and HealthComp are now Personify Health. The industry’s first personalized health platfor...
  • 8 Days Ago

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Medical Billing Manager
  • Confidential
  • Providence, RI FULL_TIME
  • We are seeking a skilled and detail-oriented Medical Biller to join our team. As a Medical Biller, you will be responsible for accurately coding and billing medical procedures and services. Your role ...
  • 18 Days Ago

Rhode Island (/ˌroʊd -/ (listen)), officially the State of Rhode Island and Providence Plantations, is a state in the New England region of the United States. It is the smallest state in area, the seventh least populous, the second most densely populated, and it has the longest official name of any state. Rhode Island is bordered by Connecticut to the west, Massachusetts to the north and east, and the Atlantic Ocean to the south via Rhode Island Sound and Block Island Sound. It also shares a small maritime border with New York. Providence is the state capital and most populous city in Rhode Is...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Claims Review Manager jobs
$102,337 to $130,481

Medical Claims Review Manager in Parkersburg, WV
This end-to-end e-billing and e-payment solution is fully integrated with DecisionPoint, which means it can be immediately and easily integrated with your providers, adjusters, IT infrastructure, and claims workflow—enabling you to.
January 01, 2020
Medical Claims Review Manager in Juneau, AK
Examples include a claims examiner’s view of a particular bill’s status in a claim record’s related bill screen, or a bill review analyst’s view of an available reserve amount for the claim record related to the bill they are processing.
December 03, 2019
Medical Claims Review Manager in Galveston, TX
Assists the Manager, Medical Review with performing duties to oversee day-to-day activities within the Medical Claims Review Department to facilitate the achievement of business goals and targets.
December 16, 2019