Claims Processing Director jobs in Gainesville, FL

Claims Processing Director plans and directs one or more departments responsible for administration of health insurance claims, payment processing, billing research, and responding to inquiries. Establishes and implements organizational policies and procedures; may offer guidance on the appropriate handling of complex or high-value claims. Being a Claims Processing Director develops and executes strategic business plans for the department. Coordinates operations with other areas of the organization. Additionally, Claims Processing Director requires a bachelor's degree. Typically reports to top management. The Claims Processing 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 Processing 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)

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Director of Processing Engineering
  • AdventHealth Ocala
  • Ocala, FL FULL_TIME
  • Description


    Director of Processing Engineering AdventHealth Ocala

    Location Address: 1500 SW 1st Ave Ocala, Florida 34471

    Top Reasons To Work At AdventHealth Ocala

    • Horse Capital of the World – Home to the World Equestrian Center
    • Affordable cost of living
    • Destination for outdoor enthusiast (golf, kayaking, horseback riding, nature trails)
    • Vibrant downtown area with award winning establishments
    • Family friendly with many parks and recreations
    • Driving distance to Gainesville, St. Augustine, Orlando, Tampa, Sarasota
    • Part of the community since 1898, providing healthcare to Marion County for over 120 years
    • AdventHealth Hospital Ocala offers a broad spectrum of services, with programs that are nationally recognized and accredited
    • Spectacular springs throughout the county

    Work Hours/Shift:

    Full-Time/ Days


    You Will Be Responsible For:

    • Fully develop and implement a comprehensive improvement plan that derives from and complements the organizational strategic plan.
    • Systematically integrate innovative structures, methods and cultural practices into the implementation of Lean.
    • Work with administration to identify the top DRGs that have opportunity for improvement and Lean processing in order to improve overall costs and quality. Lead workgroups to establish projects in order to facilitate change in those areas to result in desired outcomes.
    • Strengthen value stream teams by providing expert support, service and training to accelerate improvements and build team member enthusiasm across the organization. Build a broad constituency of team members at all levels, trained in continuous improvement that feel empowered to use the tools on a daily basis.
    • Fully develop and implement line-of-sight metrics across the organization to define the gaps and drive continuous measurable results.
    Qualifications


    What You Will Need:

    • Bachelor’s degree in Business, Healthcare or related field
    • Strong facilitation and presentation skills
    • Advanced skills using Microsoft Office including Word, PowerPoint and Excel
    • Three-five years of organizational management or consulting
    • Over ten years of experience in the field
    • Solid experience in process implementation and change management
    • Strong analytical and financial experience

    Job Summary:

    The Director of Process Engineering is responsible for clearly identifying the current state of the organization’s performance, laying out the vision for creating a systemic, culture-driven transformation, and then directing the tactical execution necessary to achieve desired outcomes. The director reports to the Chief Operating Officer, and is a key organizational leader contributing to strategy deployment, cultural leadership and operational execution. In conjunction with value stream and executive leaders, the director has responsibility for the continued development of a Lean operating system designed to drive exceptional results in customer value, quality, safety, productivity and ultimately operating and financial performance.


    This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.
  • 7 Days Ago

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Claims Adjuster
  • Sentara
  • Gainesville, FL FULL_TIME
  • Scope of position: The Claims Adjuster is responsible for performing centralized appeal processing functions for AvMed physicians, facilities, and ancillary providers. Identify claims problems and pro...
  • 9 Days Ago

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Claims Coordinator
  • TESTMASTERS, INC
  • Lake, FL FULL_TIME
  • Insurance claims creation Manage insurance claims rejections Ensure timely and accurate insurance claim payments Incoming fax management Maintain insurance payor records and requirements Job Type: Ful...
  • 27 Days Ago

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Processing technician
  • Viridian Staffing
  • Gainesville, FL FULL_TIME
  • Job Description Have you always wanted to work in the Cannabis industry? Do you have an exceptional work ethic, are attentive to details, and are always able to arrive on time ready to give 100%? If s...
  • Just Posted

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Sterile Processing Tech | Sterile Processing - Contract - Nights
  • HealthTrust Workforce Solutions
  • Gainesville, FL FULL_TIME
  • Entrust Your Career to HealthTrust! At HealthTrust, we believe that healthcare is not defined by the four walls in which it is practiced. It’s defined by its people. We pride ourselves on crafting opp...
  • 3 Days Ago

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Sterile Processing Tech | Sterile Processing - Contract - Days
  • HealthTrust Workforce Solutions
  • Gainesville, FL FULL_TIME
  • Entrust Your Career to HealthTrust! At HealthTrust, we believe that healthcare is not defined by the four walls in which it is practiced. It’s defined by its people. We pride ourselves on crafting opp...
  • 3 Days Ago

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0 Claims Processing Director jobs found in Gainesville, FL area

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Rehab Director (OT) / Senior Living
  • Healthpro Heritage
  • Gainesville, FL
  • OverviewExciting PROGRAM MANAGER/OT PART-TIME Opportunity to join our Rehab Team! Part-time with us is anywhere between ...
  • 4/23/2024 12:00:00 AM

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Psychological services Director-FC - 60007666
  • State of Florida
  • Gainesville, FL
  • Requisition No: 795508 Agency: Children and Families Working Title: PSYCHOLOGICAL SERVICES DIRECTOR-FC - 60007666 Positi...
  • 4/22/2024 12:00:00 AM

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PSYCHOLOGICAL SERVICES DIRECTOR-FC - 60007666
  • MyFlorida
  • Gainesville, FL
  • PSYCHOLOGICAL SERVICES DIRECTOR-FC - 60007666 Date: Apr 5, 2024 Location: GAINESVILLE, FL, US, 32641 The State Personnel...
  • 4/22/2024 12:00:00 AM

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Director of Quality and Risk
  • Encompass Health
  • Ocala, FL
  • The Quality/Risk Director is responsible for an environment and culture that enables the hospital to fulfill its mission...
  • 4/22/2024 12:00:00 AM

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Director, Financial Aid Operations
  • Santa Fe College
  • Gainesville, FL
  • Salary: $62,016.00 Annually Location : Northwest Campus, Gainesville Job Type: Full-Time Job Number: 23-0298R2 Division:...
  • 4/21/2024 12:00:00 AM

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Development Assistant
  • University of Florida
  • Gainesville, FL
  • Classification Title: Development Assistant Job Description: Reporting to the Advancement Administrative Specialist, the...
  • 4/21/2024 12:00:00 AM

Gainesville is located at 29°39'55" North, 82°20'10" West (29.665245, −82.336097), which is roughly the same latitude as Houston, Texas. According to the United States Census Bureau, the city has a total area of 62.4 square miles (161.6 km2), of which 61.3 square miles (158.8 km2) is land and 1.1 square miles (2.8 km2) is water. The total area is 1.74% water. Gainesville's tree canopy is both dense and species rich, including broadleaf evergreens, conifers, and deciduous species; the city has been recognized by the National Arbor Day Foundation every year since 1982 as a "Tree City, USA". Gain...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Processing Director jobs
$143,542 to $192,893
Gainesville, Florida area prices
were up 1.5% from a year ago

Claims Processing Director in Portsmouth, NH
Insurance claims and processing clerks work closely with insurance brokers and agents, handling the administrative duties behind insurance policy renewals, claims processing and new policies.
December 28, 2019
Claims Processing Director in Santa Barbara, CA
Complete with new dashboards, reporting functionality, business intelligence tools, and improved security, FileHandler Enterprise is the new benchmark for Claims Management Software.
February 08, 2020
Claims Processing Director in San Diego, CA
Pulpstream makes it possible for you to have one system for tracking all claims.
January 07, 2020