Claims Processing Director jobs in Phoenix, AZ

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 Claims
  • Jewish Family & Children's Service
  • Phoenix, AZ FULL_TIME
  • Jewish Family and Children’s Service’s (JFCS) values each and every talented applicant, regardless of religious beliefs, race, age, origin, gender, sexual orientation, or cultural background. JFCS places a high value on inclusion and diversity, whether that applies to our employees or the nearly 40,000 clients receiving our services throughout the Valley.

    Director of Claims: This role directs the claims functions of JFCS and is accountable for business results through cost-effective and timely resolution of claims. In conjunction with Senior Management, the Claims Director works within assigned limits of the highest authority on assignments requiring a high degree of technical complexity and coordination.

    Duties include:
    • Utilizing revenue cycle management best practices and compliant processes, manages claims submission, payment reporting, and claims collections to contribute to organizational sustained profitability.
    • Manages the Claims Department personnel and ancillary expenditures to maintain budgetary targets and control expenses.
    • Creates policies and procedures to prevent fraud, diminish incorrect billings and assure ethical claims administration outcomes.
    • Devises training programs to engage staff in processing claims correctly avoiding excessive rebilling of claims, claims denials and aged claims.
    • Develops strategies and collaborates with senior management to reconcile claims timely, review associate documentation and prevent claims denials.
    • Maintains currency and possesses full knowledge of billing requirements for all Payers, State Agencies and Federal programs and changes of existing practices and methods and keeps the CFO/COO updated on all impactful guidelines.
    • Manages, instructs, and directs staff toward claims administration objectives that assure productivity, profitability and task efficiency.
    • Effectively coordinates with Client Eligibility to manage client/insurance coverage related claims.
    • Audits and conducts file reviews to ensure staff are compliant with insurance laws, claims and policy guidelines.
    • Directs the work of claims staff to ensure deadlines and timelines are met and designated goals and objectives achieved.
    • Ensures reconciliation of cash received to cash posted is completed on a monthly basis.
    • Manages third party claims.
    • Performs other tasks as assigned.

    Qualifications:
    • Ten years of experience in directing claims administration preferably in a non-profit or an equivalent of private/public sector experience.
    • Adeptness utilizing Next Gen, Excel and other data analytical technology.
    • Ability to speak and write with clarity.
    • Bachelor’s degree or an equivalent amount of experience and training in financial and data analytics, or behavioral claims administration.

    Benefits of Working with JFCS:
    • Bonus Programs for both full-time and part-time employees.
    • FREE Primary HealthCare to all employees and every member of their household, regardless of relationship. This includes virtual doctor's visits, physicals, lab tests, x-rays, vaccinations, prescriptions, and telehealth.
    • Generous Employee Referral Bonuses for both the new-hire and the referring employee.
    • Bilingual (Spanish-English) Pay Differential.
    • Flexible Scheduling and Telehealth Flexibility for many positions.
    • 401(k) Retirement Plan, with Company Match.
    • We offer tuition and clinical license reimbursement.
    • Numerous professional development and career growth opportunities.
    • Generous paid time off / sick time allocations.
    • Comprehensive Employee Benefits package, including medical, vision, dental, & more.
    • Wellness Coaching.
    • Employee Assistance Program.
    • Eligibility for Loan Forgiveness Programs in many positions.
  • 1 Month Ago

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AZ - Property Claims Adjuster
  • Copper Claims Services, Inc.
  • Phoenix, AZ FULL_TIME
  • 1099 Property Claims Adjuster Copper Claims Services is a quickly growing independent loss adjusting firm based out of Irvine, CA. Copper Claims Services excels in providing custom claims solutions fo...
  • 1 Month Ago

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Auto Bodily Injury Adjuster
  • TheBest Claims Solutions
  • Phoenix, AZ FULL_TIME
  • Auto Bodily Injury Adjuster PHOENIX, AZ 85044 | TEMP TO HIRE $60,000 TO $80,000 ANNUALLY, DEPENDING ON EXPERIENCE Job Description Our client, who is a National Insurance Company, is looking for an Aut...
  • 17 Days Ago

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Commercial General Liability Adjuster
  • TheBest Claims Solutions
  • Phoenix, AZ OTHER
  • Commercial General Liability Adjuster PHOENIX, AZ 85032 $35.00 TO $45.00 PER HOUR, DEPENDING ON EXPERIENCE Job Description Our client, a national insurance company, is looking to add a remote Construc...
  • 1 Month Ago

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Clinical Operations Manager
  • Sterile Processing Express
  • Phoenix, AZ FULL_TIME
  • SUMMARY: The Clinical SPD Manager is responsible for providing effective leadership and directing 24/7 operations of the SPDx Sterile Processing facility to deliver quality, efficient, cost-effective ...
  • 1 Month Ago

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Human Resources Assistant (Military/Office Automation)
  • U.S. Military Entrance Processing Command
  • Phoenix, AZ FULL_TIME
  • About the Position: The mission of USMEPCOM is to process individuals for enlistment or induction into the armed services, based on DoD-approved peacetime and mobilization standards. First Cutoff Date...
  • 22 Days Ago

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0 Claims Processing Director jobs found in Phoenix, AZ area

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Litigation Attorney
  • Manning Kass
  • Phoenix, AZ
  • Join Manning | Kass LLP, a top-tier law firm with a proven track record of success in bad-faith lawsuits, extensive tria...
  • 4/26/2024 12:00:00 AM

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Claims Manager
  • Davis Search
  • Phoenix, AZ
  • Overview: Highly regarded NYSE Insurance company is seeking a Claims Manager (Director depending upon level of experienc...
  • 4/26/2024 12:00:00 AM

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Administrative Assistance
  • Peyton Resource Group (PRG)
  • Phoenix, AZ
  • Job Description Job Description Administrative support will send emails on behalf of 4 Directors, use Excel for differen...
  • 4/26/2024 12:00:00 AM

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Property Adjuster - CAT (In Office)
  • Usaa
  • Phoenix, AZ
  • Why USAA? Lets do something that really matters! At USAA, we have an important mission: facilitating the financial secur...
  • 4/26/2024 12:00:00 AM

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Injury Adjuster
  • USAA
  • Phoenix, AZ
  • Why USAA? Lets do something that really matters. At USAA, we have an important mission: facilitating the financial secur...
  • 4/26/2024 12:00:00 AM

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Inside Sr. Property Adjuster
  • USAA
  • Phoenix, AZ
  • Why USAA? Lets do something that really matters. At USAA, we have an important mission: facilitating the financial secur...
  • 4/25/2024 12:00:00 AM

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Sr. Auto Adjuster (CAT Team)
  • Usaa
  • Phoenix, AZ
  • Why USAA? Lets do something that really matters. At USAA, we have an important mission: facilitating the financial secur...
  • 4/24/2024 12:00:00 AM

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SENIOR INSURANCE ANALYST
  • Arizona State Government
  • Phoenix, AZ
  • DEPARTMENT OF INSURANCE AND FINANCIAL INSTITUTIONSThe Department of Insurance and Financial Institutions licenses, monit...
  • 4/23/2024 12:00:00 AM

Phoenix is in the southwestern United States, in the south-central portion of Arizona; about halfway between Tucson to the southeast and Flagstaff to the north. By car, the city is approximately 150 miles (240 kilometers) north of the US-Mexico border at Sonoyta and 180 mi (290 km) north of the border at Nogales. The metropolitan area is known as the "Valley of the Sun" due to its location in the Salt River Valley. It lies at a mean elevation of 1,086 feet (331 m), in the northern reaches of the Sonoran Desert. Other than the mountains in and around the city, the topography of Phoenix is gener...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Processing Director jobs
$156,707 to $210,584
Phoenix, Arizona area prices
were up 2.2% 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