Top 177 Insurance claims manager Jobs in Nevada

Manager, Special Investigation Unit (SIU)
Centene —Nevada
- $87,700 - $157,800 a year
- Full-time
- Remote
- Management
- Mid-level
- Supervising experience
- Paid holidays
- Health insurance
17h
Case Manager, Registered Nurse (Oncology experience required)
CVS Health —Nevada
- $54,095 - $155,538 a year
- Full-time
- Remote
- Spanish
- Nursing
- RN License
- Health insurance
- Dental insurance
Lead Workers’ Compensation Attorney
Orion Placement —Las Vegas, NV
- $170,000 - $200,000 a year
- Full-time
- 5 years
- Mentoring
- In-person
- Relocation assistance
- Dental insurance
Quick Apply
Senior Construction Project Manager
Confidential —Las Vegas, NV
- $80,000 - $90,000 a year
- Full-time
- OSHA
- Customer service
- 5 years
- Health insurance
- Dental insurance
Quick Apply
Dental Billing Manager
Confidential —Las Vegas, NV
- $25 - $30 an hour
- Full-time
- Dental office
- Mid-level
- In-person
- Paid holidays
- Disability insurance
Quick Apply
9d
Home Health Clinical Manager - RN ($10K Relocation!)
Mission Healthcare —Carson City, NV
- $125,000 - $135,000 a year
- Monday to Friday
- CPR Certification
- Nursing
- BLS Certification
- Mileage reimbursement
- Health savings account
Quick Apply
7d
Medical Billing Lead (Bilingual) - Pediatrics
Nevada Pediatric Specialists —Henderson, NV
- $18 - $25 an hour
- Full-time
- Spanish
- English
- Mid-level
Quick Apply
Construction Project Manager
Alorah Healthcare —Las Vegas, NV
- Weekends as needed
- Construction site
- 5 years
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Workers' Compensation Claims Manager
Shook and Stone CHTD —Reno, NV
- Full-time
- Spanish
- English
- Mid-level
Quick Apply
Project Manager
Everforth —Las Vegas, NV
- $115,000 - $145,000 a year
- Full-time
- Construction site
- 5 years
- Driver's License
- Health insurance
- Dental insurance
Quick Apply
Project Manager (Mining Construction - Civil / Earthworks)
MineSpec —Reno, NV
- $161,000 - $196,000 a year
- Full-time
- Civil engineering
- Construction site
- 8 years
- Opportunities for advancement
Quick Apply
Account Manager - State Farm Agent Team Member
Erik Simonis - State Farm Agent —Las Vegas, NV
- $55,000 - $82,500 a year
- Full-time
- Spanish
- Mid-level
- Office
- Paid holidays
- Paid time off
Quick Apply
Nurse Manager
US Veterans Health Administration —Fallon, NV
- $105,151 - $190,708 a year
- Online Application
- Background check
- Nursing
- Doctoral degree
- Paid holidays
- Loan repayment program
4d
Lead SIU Investigator
Centene —Nevada
- $70,100 - $126,200 a year
- Full-time
- Remote
- Master's degree
- High school diploma or GED
- Mentoring
- Paid holidays
- Health insurance
1d
Contract Manager, Infrastructure
Brightline West —Las Vegas, NV
- Full-time
- Mid-level
- Organizational skills
- Communication skills
Quick Apply
Property & Casualty Insurance Claims Operations Consultant, Manager
PRICE WATERHOUSE COOPERS —Las Vegas, NV
- $99,000 - $232,000 a year
- Mid-level
- Finance
- Bachelor's degree
- Paid holidays
- Health insurance
Program Integrity Manager
CVS Health —Carson City, NV
- $54,300 - $145,860 a year
- Full-time
- Hybrid work
- 5 years
- Office
- Analysis skills
- Health insurance
- Dental insurance
7d
Market Finance Lead
Humana —Nevada
- $104,000 - $143,000 a year
- Full-time
- CPA
- Office
- Master's degree
- Paid parental leave
- Paid holidays
Risk Claims Manager
CrossCountry Freight Solutions, Inc. DBA CCFS —Las Vegas, NV
- $85,000 - $95,000 a year
- Full-time
- 7 years
- Windows
- Analysis skills
Quick Apply
7d
OGC | Manager - Legal Administration
Deloitte —Las Vegas, NV
- $93,000 - $191,000 a year
- Full-time
- Microsoft Word
- 5 years
- Office

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insurance claims manager jobs near nevada

Manager, Special Investigation Unit (SIU)

Centene -
Nevada

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Job Details

Full-time
$87,700 - $157,800 a year
17 hours ago

Benefits

Paid holidays
Health insurance
401(k)
Tuition reimbursement
Paid time off
Vision insurance

Qualifications

Staff performance monitoring
Appeals
Healthcare financial misconduct investigations
Committee work
Data mining
Management
Medical claims processing
Managed care organization experience
Spreadsheets
Overseeing healthcare denial management
Medical Coding Certification
Medical coding
Regulatory compliance in claims processing
Bachelor's degree in business
Business analysis
Dental insurance
Medical billing compliance checks
Mid-level
Refund processing
Financial analysis
Criminal Justice
Hiring
Supervising experience
Staff training
Medical insurance appeals management
Insurance investigations
Managing insurance claims teams
Fraud prevention policy implementation
Instructional materials development
4 years

Full Job Description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

*This is a remote role within the continental US.*

Position Purpose: Develop, implement and manage strategic fraud, waste and abuse activities by maintaining state and federal requirements and monitoring trends and schemes.

Monitor business processes and systems to assure integrity and compliance in billing and claims payment
Lead a team appropriately investigate all possible fraud, waste and abuse referrals
Develop educational materials to address/identify waste activities as requested by the health plan and on an ad-hoc basis
Attend state/federal meetings as required by specific contracts
Review post-payment cases with appropriate parties to obtain refund
Prepare and distribute monthly and quarterly saving reports
Participate in Appeals Committee, work groups and interdepartmental meetings

Education/Experience:

Bachelor’s degree in Business, Healthcare, Criminal Justice, related field, or equivalent experience.
4+ years of combined medical claim investigation, financial impact analysis, business analysis, compliance or fraud and abuse experience.
Thorough knowledge of medical terminology.
Experience working with Dental and Vision plans.
Previous experience in managed care environment and as a lead or supervisor of staff, including hiring, training, assigning work and managing performance preferred.
Knowledge of Microsoft Excel, medical coding, claims processing, and data mining preferred.

License/Certification:

Medical records or coding license preferred.

Pay Range: $87,700.00 - $157,800.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Apply Now

Refine Your Search

insurance claims manager jobs in nevada

Manager, Special Investigation Unit (SIU)

Case Manager, Registered Nurse (Oncology experience required)

Lead Workers’ Compensation Attorney

Senior Construction Project Manager

Dental Billing Manager

Home Health Clinical Manager - RN ($10K Relocation!)

Medical Billing Lead (Bilingual) - Pediatrics

Construction Project Manager

Workers' Compensation Claims Manager

Project Manager

Project Manager (Mining Construction - Civil / Earthworks)

Account Manager - State Farm Agent Team Member

Nurse Manager

Lead SIU Investigator

Contract Manager, Infrastructure

Property & Casualty Insurance Claims Operations Consultant, Manager

Program Integrity Manager

Market Finance Lead

Risk Claims Manager

OGC | Manager - Legal Administration

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