Remote Medical Claims Review Director
Colorado Psychiatric
- Remote job
Optum seeks a Medical Director to provide physician support for Enterprise Clinical Services, focusing on post-service benefit determinations and medical necessity decisions. You will lead clinical reviews, collaborate with hospital networks, and contribute to cost-effective care decisions. The role requires an MD/DO with active license, board certification, 5+ years of practice, and strong communication skills; remote-friendly with comprehensive benefits. #J-18808-Ljbffr Colorado Psychiatric
$248.5k - $373k
...00 - $373,000/yearJob Area: Medical & Clinical OperationsCompany... ...clinical coverage and medical claims reviews. Our role is to empower... ...health care costs.The Medical Director provides physician support to... ...skills*All employees working remotely will be required to adhere...Remote workMedicalMinimum wageFull timeWork experience placementLocal area- Optum in the United States is seeking a Medical Director to provide physician support to Enterprise Clinical Services, guiding clinical and... ...physicians. You will collaborate with a multidisciplinary team, review policies, and ensure cost-effective, high-quality care for...Remote jobMedical
- Optum, a part of UnitedHealth Group, is seeking a Medical Director to provide physician support for Enterprise Clinical Services, shaping benefit... ...-quality care. Responsibilities include conducting coverage reviews, documenting findings, and engaging in peer-to-peer...Remote jobMedical
- ...Claims Technical Director Casualty - Auto Liability For more than 170 years,... ...an exempt, full time, fully remote or hybrid out of our Itasca... ...Conduct detailed technical reviews of claim files to ensure thorough... .... Benefits include: ~ Medical, dental, vision, life, and...Remote workMedicalFull timeTemporary workWork at officeWork from homeFlexible hours
$88.69k - $141.68k
...of work.Low contributions to medical and prescription premiums. We... ...monitors the activities of assigned claims adjusters and other claims... ...policies, including access to a remote work bank.Duties and... ...Employee development as required.Reviews claims on a regular basis in accordance...Remote workMedicalFull timeTemporary workWork at officeWork from homeHome office$98k - $126.5k
Job DescriptionThe Claims Supervisor, SIU will oversee the operation... ...and control the work of remote SIU Investigators and Analysts... ...through effective leadership.Review active and closed files in compliance... ...options that start on Day 1 (medical, dental, vision)Robust health...Remote workMedicalWork at office$48 - $57 per hour
...8 team members in the default claims filing team and acting as the... ...Managing team members in a mostly remote environment who are located... ...prepare and present performance reviews for staffOrders and prepares... ...may include the following: • Medical, dental & vision • Critical...Remote workMedicalContract workTemporary workLocal area$85.04k - $162.55k
.... USAA roles may offer remote or hybrid flexibility for... ...seeking a dedicated Claims Litigation Manager - Section... ..., and/or trials.Reviews, audits, and approves legal... ...of the USAA Board of Directors.The above description reflects... ...include comprehensive medical, dental and vision...Remote workMedicalFull timeContract workWork experience placementH1bWork at officeHome officeRelocation packageFlexible hours3 days per week$73.35k - $113.25k
...Workers' Compensation Claims Supervisor The Workers' Compensation... ...and CorVel. This is a remote work arrangement. Essential... ...Participate in customer claim reviews and presentations Ability to... ...regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision...Remote workMedicalMinimum wageFull timeWork at officeLocal areaFlexible hoursNight shift$103k - $131.5k
...Benefits: Choose from three medical plans, and access... ...Reporting directly to the Director of Insurance and Risk... ...the Risk Management GL claim function.... ...programs. Conducts a review of the performance of third... ...Monday and Friday are remote days. In accordance...Remote workMedicalWeekly payWork at officeMonday to FridayFlexible hours$73.35k - $113.25k
...Workers' Compensation Claims SupervisorThe Workers' Compensation Claims... ...and CorVel. This is a remote position.Essential Functions &... ...requestsParticipate in customer claim reviews and presentationsAbility to... ...employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision...Remote workMedicalMinimum wageFull timeWork at officeLocal areaFlexible hoursNight shift$103.45k - $197.73k
.... USAA roles may offer remote or hybrid flexibility for... ...a dedicated Manager, Claims Operations, you will lead... ...'ll do: Inspects and reviews quality of claim files... ...discretion of the USAA Board of Directors. The above description... ...include comprehensive medical, dental and vision...Remote workMedicalWork at officeRelocation packageFlexible hours$40.96k - $61.44k
...Join to apply for the Claims Case Manager I, Supplemental... ...letter if applicable Review claim documentation to... ...claim management (medical information, accident details... ...This is a mobile (remote) position. Salary Range... ...Manager” roles. Managing Director - Insurance, Caribbean...Remote workMedicalFull timeWork experience placementFlexible hours$50.78k - $84.64k
...high ethical standards. The Claims Supervisor Role The Claims... ...areas of concern found in routine review activity and/ or processing,... ...zones. ~ As this role is a remote role, you are required to... ...compensation package. Excellent medical, dental, supplemental health,...Remote workMedicalContract workWork at officeLocal areaFlexible hours- ...DETAILS Reports To: Division Claims Manager FLSA Status: Exempt Job... ...remaining days can be worked remotely if technical requirements are... ...daily claims decisions, review files for accuracy, and approve... ...communication Discuss appropriateness of medical treatment with medical case...Remote workMedicalTraineeshipWork at officeImmediate startMonday to FridayFlexible hoursNight shift1 day per week
$105k - $118k
...Financial Services & Insurance Claims Team Lead (Supervisor) -... ...Hybrid (3 days in office, 2 days remote) PRIMARY PURPOSE OF THE ROLE:... ...adjudication, including quality reviews and reserve evaluations for high... ...benefits offering including medical, dental vision, 401K on day one...Remote workMedicalWork at officeFlexible hours- ...Portsmouth, NH Work Setting: Remote or hybrid; must reside in NH,... ...Employment Type: Full-Time Reports To: Claims and EDI Manager FLSA Status:... ..., MOHS authorization review, peer-to-peer coordination, and... ...surgeons, dermatology providers, medical assistants, reception, EDI, and...Remote workMedicalFull timeWork at office
$75k - $85k
...modern pet care. About The Role In this remote role , you will be our people manager overseeing a team of 10‑15 claim adjusters. The key skills required fall into... ...claims according to policy terms, review medical records, process determinations, verify coverage...Remote workMedicalFull timeWork at officeWork from homeFlexible hours- ...A peer review organization is seeking a full-time remote Utilization Management Physician Reviewer. Ideal candidates must hold an MD, DO, or DPM degree with active board certification and unrestricted medical license in relevant states. The role involves performing detailed...Remote workMedicalFull timeWork from home
- ...Dane Street, LLC is hiring a Peer / Record Review Quality Analyst responsible for managing medical file reviews and ensuring client standards are met. The ideal candidate must have strong communication skills, an educational background in healthcare or business, and...Remote workMedicalWork from home
- ...Description Job Description Claims Manager – Personal Injury Law... ...| In-Office Position (No Remote Work) Position Summary We... ...with attorneys, case managers, medical providers, and insurance companies... ...premises liability cases • Review case files to evaluate...Remote jobMedicalFull timeWork at officeMonday to Friday
- ...Mass Digital Health is seeking a Clinical Reviewer LPN for a work-from-home position. The role involves performing retrospective medical reviews based on patient eligibility and contract... ...setting, and the ability to work in a remote environment. Comprehensive benefits are...Remote workMedicalContract workWork from home
- ...Job Description Job Description Remote but must be able to get to Newark, Nj to pick up... ...Responsibilities: 1. Conducts on-site/virtual reviews at participating provider offices to assess environment, quality of physicians medical records, and compliance with documentation...Remote workMedical
$84k - $119k
...currently have an opportunity for a Claim Supervisor to join our Ocean... ...in our Atlanta, GA office or remotely nationwide. The Claim... ...daily work of direct reports. Reviews and provides technical direction... ...paid time off programs, medical, vision and dental plans, mental...Remote workMedicalFull timeWork at office- ..., finance, accounting, and contracts. Claims Manager Role Overview:... ...minimize financial exposure. Open Claim Review & TPA Performance Monitoring Lead regular... ...What We Can Offer You: Inclusive Medical, Dental, Vision, Accident, and Illness insurance...Remote workMedicalFull timeContract workWork at office
$75k - $98k
...Angeles, CA 90010, USA Los Angeles | Remote/In-Office (In-Office Preferred) |Auto Insurance Claims Pay Range: $75,000- $98,000 Per... ...required. What do we offer? Medical, Dental, Vision, Supplemental... ...For further information, please review the Know Your Rights notice from...Remote workMedicalWork at officeFlexible hours$110k - $140k
Department: Claims Job Description We are seeking an experienced Claims... ...and cost containment goals. Review pleadings, motions, discovery,... ...-term disability insurance Medical, dental and vision plans to meet... ...work schedules and hybrid/remote options for eligible positions...Remote workMedicalTemporary workWork at officeHome officeFlexible hours$70k - $95k
...currently an experienced Casualty Claims Supervisor looking to join a... ...Conduct file and diary reviews for the purpose of monitoring... ...to your Training & Development Medical and Dental Short Term Disability... ...position is in-office, hybrid or remote. #J-18808-Ljbffr First Chicago...Remote workMedicalFull timeTemporary workWork at officeLocal areaFlexible hours- ...Optum is seeking a Utilization Review Nurse, RN to manage inpatient utilization review and preauthorization... ...documentation of clinical reviews, applying medical necessity criteria, and coordinating with Medical Directors. Remote options are available for eligible candidates....Remote workMedical
- ...IntePros is seeking a Physician Reviewer to provide remote support for a healthcare organization. The role involves reviewing medical necessity determinations and applying InterQual criteria. Candidates should have an MD or DO, active board certification, and a background...Remote workMedical
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