Claims Director directs and oversees the operations of an insurance claims department to meet operational, financial, and service requirements. Establishes policies and procedures for the administration of insurance claims for personal, property, or casualty loss based on coverage, appraisal, and verifiable damage. Being a Claims Director is responsible for the strategic processing and payment of claims. Maintains up-to-date- knowledge of legislation, regulations, and industry events which pertain to insurance claims. Additionally, Claims Director provides expert guidance and consultation to staff on the most complex claims. Requires a bachelor's degree. Typically reports to top management. The Claims Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. To be a Claims Director typically requires 5+ years of managerial experience. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. (Copyright 2024 Salary.com)
9 - 12 Years Healthcare experience must
9 - 12 years of experience in US Healthcare Payor operation.
Including, 7-10 years of experience in managing teams,
Strong operational & people management skill with experience of handling minimum of 100 employees
Working & Team handling Experience in claim adjudication/ Payment integrity/Enrollment
Excellent communication & interpersonal skills; team oriented and strong consensus building
Advanced knowledge of MS Word, MS Excel and Data management
Ability to operate in a rapidly changing environment with a sense of urgency, and to develop and deploy changes positively
Demonstrated analysis and problem solving abilities
Strong organizational and time management skills
The ability to multitask and self-manage workday is crucial.
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