New Jersey Licensed Clinical Claims Manager

Job Summary

A company is looking for a Manager of Post Service Clinical Claims Review.

Key Responsibilities

• Direct and manage operational functions within Post-service Claims Reviews, Clinical Coding, and Reimbursement Policy
• Provide leadership to teams focusing on process improvement and quality enhancements
• Oversee the development and implementation of Clinical Coding integrated into Medical and Reimbursement policies

Required Qualifications

• High School Diploma/GED required; Bachelor's degree preferred in Nursing or related field
• Minimum of ten (10) years of experience in healthcare and clinical operations
• Five (5) years of supervisory experience required
• Experience managing multiple projects with cross-functional teams
• Active Unrestricted RN License required