Claims Quality Review Manager

Job Summary

A company is looking for a Manager, Claims Quality Review.

Key Responsibilities

• Manage the Claims Quality Analysts to perform quality reviews of high-risk claims and provide immediate feedback
• Conduct focus reviews of claims to identify root causes of errors and propose solutions
• Build relationships with stakeholders to ensure timely project completion and track claims quality trends

Required Qualifications

• Bachelor's degree in Healthcare Administration, Business Administration, Management Information Systems, or a related field
• 4+ years of experience in health insurance or claims processing
• Previous leadership experience managing cross-functional teams on large-scale projects
• Experience in hiring, training, and managing staff performance
• Authorization to work in the U.S. without the need for employment-based visa sponsorship