Clinical Bill Review and Treatment Plan Team Manager
113692
Zurich Insurance is seeking a Clinical Bill Review and Treatment Plan Team Manager. This position is 100% remote.
The Clinical Bill Review and Treatment Plan Team Manager will be responsible for overseeing the team that reviews and evaluates medical bills and creates treatment plans for Zurich's Workers Compensation claims. The manager will ensure that the team is accurately reviewing medical bills and creating treatment plans to ensure that they are following policies, procedures, clinical guidelines, and jurisdictional requirements. The manager will also be responsible for managing and training the team members, managing the quality assurance program with our external vendors, and identifying areas for process improvement.
This fully remote position involves leading, managing and developing a team of multi-specialty Nurses. The teams overall focus is on the handling of medical bills and treatment of Injured employees.
Key Responsibilities:
Oversee day-to-day operations, including monitoring, leading, and directing the team in their day-to-day activities
Managing the Quality Audit process with our external vendor
Implement strategic plans to enhance managed care functions by evaluating and improving business processes and best practices
Respond to all inquiries professionally and accurately by researching issues, determining root causes, and implementing solutions
Lead and motivate a high-performance team, including attracting, onboarding, recruiting, and retaining team members
Develop and implement process improvements to enhance efficiency
Collaborate with Technical Claims teams to integrate managed care functions into the clinical bill review and treatment plan process
Manage performance by setting job expectations, monitoring, and evaluating performance, providing feedback, and facilitating employee development
Maintain transparent communication through regular meetings, emails, and interpersonal interactions
Foster a workplace culture aligned with Zurich's mission, vision, and values
Encourage continuous improvement in medical expertise within the team
Protect Zurich's reputation by maintaining confidentiality of claims information
Stay current with industry trends through educational opportunities and networking
Contribute to team efforts by participating in projects as needed
Basic Qualifications:
Bachelor's Degree and 3 or more years of experience in the Bill Review area, OR
High School Diploma or Equivalent and 5 or more years of experience in the Bill Review area
2 or more years of management experience
Knowledge of CPT and ICD-9 codes and medical terminology
Proficiency with Microsoft Office
Preferred Qualifications:
Master's degree in Nursing or Health Care
Bachelor's Degree in Nursing and 3 or more years of experience in Bill Review and Case Management
Knowledge of ODG, MTUS, State Guidelines
Experience in developing and implementing cost containment programs.
Certifications such as CRRN, CDMS, CCM, or COHN.
3-5 years of leadership experience in Nurse Case Management and Bill Review within a team setting
Proficiency with Microsoft Office
Some knowledge of Bill Review systems
Experience managing and leading in a remote environment
Workers Compensation Insurance industry experience
Strong verbal and written communication skills
Compensation for roles at Zurich varies depending on a wide array of factors including but not limited to the specific office location, role, skill set, and level of experience. As required by local law, Zurich provides in good faith a reasonable range of compensation for roles. For additional information about our Total Rewards, clickhere (https://www.zurichna.com/careers/benefits) . Other rewards may include short term incentive bonuses and merit increases. Candidates with salary expectations outside of the range are encouraged to apply, and will be considered based on experience, skill, and education. The salary provided is a nationwide market range and has not been adjusted for the applicable geographic differential associated with the location where the position may be filled. The starting salary range for this position is $96,300.00 - $157,700.00.
As a condition of employment at Zurich, employees must adhere to any COVID-related health and safety protocols in place at that time ( https://www.zurichna.com/careers/faq ).
A future with Zurich. What can go right when you apply at Zurich?
Now is the time to move forward and make a difference. At Zurich, we want you to share your unique perspectives, experiences and ideas so we can grow and drive sustainable change together. As part of a leading global organization, Zurich North America has over 150 years of experience managing risk and supporting resilience. Today, Zurich North America is a leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We serve more than 25 industries, from agriculture to technology, and we insure 90% of the Fortune 500®. Our growth strategy is not limited to our business. As an employer, we strive to provide ongoing career development opportunities, and we foster an environment where voices are diverse, behaviors are inclusive, actions drive equity, and our people feel a sense of belonging. Be a part of the next evolution of the insurance industry. Join us in building a brighter future for our colleagues, our customers and the communities we serve. Zurich maintains a comprehensive employee benefits package for employees as well as eligible dependents and competitive compensation. Please clickhere (https://www.zurichna.com/careers) to learn more.
As a global company, Zurich recognizes the diversity of our workforce as an asset. We recruit talented people from a variety of backgrounds with unique perspectives that are truly welcome here. Taken together, diversity and inclusion bring us closer to our common goal: exceeding our customers' expectations. Zurich does not discriminate on the basis of age, race, ethnicity, color, religion, sex, sexual orientation, gender expression, national origin, disability, protected veteran status or any other legally protected status. EOE disability/vet
Zurich does not accept unsolicited resumes from search firms or employment agencies. Any unsolicited resume will become the property of Zurich American Insurance. If you are a preferred vendor, please use our Recruiting Agency Portal for resume submission.
Location(s): AM - Remote Work (US)
Remote Working: Yes
Schedule: Full Time
Employment Sponsorship Offered: No
Linkedin Recruiter Tag: #LI-MD1 #LI-ASSOCIATE #LI-REMOTE