Claims Processing Director jobs in Nashville, TN
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)
Recently Added Claims Processing Director jobs
- Brookdale Corporate Nashville
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Brentwood, TN
FULL_TIME
-
Overview
Voted by Newsweek in 2024 as one of America's Greatest Workplaces for Diversity
Make Lives Better Including Your Own. If you want to work in an environment where you can become your best possible self, join us! You’ll earn more than a paycheck; you can find opportunities to grow your career through professional development, as well as ongoing programs catered to your overall health and wellness. Full suite of health insurance, life insurance and retirement plans are available and vary by employment status. Additional benefits offered include, but are not limited to:- Tuition Reimbursement
- Pet Insurance
- Adoption Reimbursement Benefits
- Variety of Associate Discounts
Responsibilities
Serves as a member of the Claims, Litigation & Risk team by actively analyzing, managing and providing legal counsel on incidents, claims, and lawsuits. This team member will also take lead on identifying and implementing risk mitigation measures.
Performs initial evaluations of professional liability and general liability claims and litigation, including research and analysis of applicable laws, application of regulations and policies as well as assessing exposure and liability, and determining litigation strategy.
Partners with, directs, and manages outside counsel on litigation strategy.
Participates in mediations, arbitrations, settlement conferences, and trials.
Proactively identifies legal risks and develops mitigation measures.
Provides legal and risk mitigation support to cross-functional teams through the claims and litigation process by conducting interviews, evaluating witness credibility, analyzing and compiling records and documents, and preparing status updates on litigation and claim.
Reviews and assists in the preparation of material pleadings.
Coordinates and oversees the record production process. Handles confidential, sensitive, proprietary and privileged information, reviews requests, assesses production costs and expenses, and conducts review and evaluation of records for relevance, responsiveness, and privileged.
Provides legal advice to cross-functional teams.
Operates independently and in coordination with other members of the Claims, Litigation and Risk team to develop and execute strategy for a variety of claims and litigation including, but not limited to, professional liability, general liability, commercial, and complex matters.
Establishes and maintains relationships, credibility, and trust with clients, stakeholders, legal team members, and other colleagues.
- Juris Doctor from an ABA accredited institution.
- Five (5) plus years litigating professional liability, general liability, and complex litigation matters.
- Ability to handle confidential, privileged, proprietary, and sensitive information required.
- Effective leadership skills.
- Strong attention to detail.
- Effective organization and communication skills.
- Standing
- Walking
- Sitting
- Use hands and fingers to handle or feel
- Reach with hands and arms
- Climb or balance
- Stoop, kneel, crouch, or crawl
- Talk or hear
- Taste or smell
- Ability to lift: up to 25 pounds
- Vision
- Requires interaction with co-workers, residents or vendors
- Occasional weekend, evening or night work if needed to ensure shift coverage
- Requires Travel: Occasionally
- Requires Driving: Drives self (Tier 2)
- 4 Days Ago
This job description represents an overview of the responsibilities for the above referenced position. It is not intended to represent a comprehensive list of responsibilities. An associate should perform all duties as assigned by his/her supervisor.
Qualifications
Education and Experience
Certifications, Licenses, and Other Special Requirements
Licensed to practice law and admitted to the bar in at least one state or the District of Columbia. Eligible for admission as an In-House Counsel in the state of Tennessee.
Management/Decision Making
Has strong analytic skills and an understanding of business organization and identifying and responding to issues. Uses sound, independent judgment and experience to perform initial evaluation and assessment of complex matters based on precedent, example, reasonableness, or a combination of these. Exercises sound judgment to identify risks and propose mitigation strategies. Effective leadership skills to direct and manage outside counsel. May present solutions to issues to a supervisor and collaborate with a team on implementation of solutions.
Knowledge and Skills
Has a proficient knowledge of the discipline and able to provide insight, advice and solutions on issues. Strong verbal and written communication skills. Team mentality. Motivated and willing to provide support to team members.
Physical Demands and Working Conditions
Salary Range Information
$110,710 - $141,031 / year- Hancock Claims Consultants
-
Nashville, TN
CONTRACTOR
- CLIMB to New Heights… And live the_ American Dream. _Become part of something bigger by contracting with the nation’s top provider of roof and property inspection services working with insurance carri...
- 2 Months Ago
- Beverage Director The Underground Cocktail Club Nashville
-
Nashville, TN
FULL_TIME
- Beverage Director-The Underground Cocktail Club Nashville The Underground Cocktail Club Is Coming to Nashville! This will be the first Underground Cocktail Club in Nashville, The Underground nightclub...
- 1 Day Ago
- Core Financial Processing Inc
-
Nashville, TN
FULL_TIME
- Ready to steer your financial future in the direction you desire? Join Core Financial Processing as a Merchant Services Sales Representative and unleash your earning potential. With our commission-bas...
- 13 Days Ago
- Core Financial Processing Inc
-
Nashville, TN
FULL_TIME
- Are you an ambitious sales professional eager to elevate your career? Core Financial Processing is actively seeking motivated individuals to join our team as Business to Business Sales Associates. Wit...
- 14 Days Ago
- U.S. Military Entrance Processing Command
-
Nashville, TN
TEMPORARY,FULL_TIME
- Duties Receive and answers routine telephone inquiries or refers to the appropriate staff. Serve as the Commander's point of contact on civilian personnel matters, requirements and suspense's. Provide...
- 10 Days Ago
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0 Claims Processing Director jobs found in Nashville, TN area
- Elevance Health
-
Nashville, TN
- Description LTSS Service Coordinator - RN Clinician Location: Montgomery County/ Clarksville, TN This is a field positio...
- 4/19/2024 12:00:00 AM
- Tennessee Secretary of State
-
Nashville, TN
- Administrative Specialist Tennessee Department of State Division of Information Technology Location: Nashville, TN Missi...
- 4/19/2024 12:00:00 AM
- Highmark Health
-
Nashville, TN
- Company : United Concordia Dental Job Description : JOB SUMMARY ******* Due to Department of Defense (DOD) contract requ...
- 4/19/2024 12:00:00 AM
- CECO CONCRETE CONSTRUCTION
-
Nashville, TN
- Are you looking for an opportunity to move your career forward with an established industry leader? Join our team at Cec...
- 4/19/2024 12:00:00 AM
- UnitedHealth Group Inc.
-
Nashville, TN
- Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. ...
- 4/18/2024 12:00:00 AM
- Holiday Inn Nashville Downtown
-
Nashville, TN
- Job Summary: The Area HR Manager will report directly to the Director of Human Resources or General Manager (property sp...
- 4/18/2024 12:00:00 AM
- Alive Hospice, Inc.
-
Nashville, TN
- Apply Description Revenue Cycle Specialist (Medicare)Full Time Location:Nashville, TNStatus:Regular Full TimeDays:Monday...
- 4/16/2024 12:00:00 AM
- Total Quality Logistics, Inc.
-
Nashville, TN
- About the role: TQL is looking for an established logistics sales leader, who has a history of success leading a team in...
- 4/15/2024 12:00:00 AM
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