Claims Processing Manager jobs in Orange, CA

Claims Processing Manager manages the administration of health insurance claims, payment processing, billing research, and responding to inquiries. Ensures timely and proper disposition of claims in accordance with coverage amounts. Being a Claims Processing Manager trains staff on organizational policies and ensures procedures are followed at all times. Provides guidance on more complex or high-value claims. Additionally, Claims Processing Manager typically requires a bachelor's degree. Typically reports to a head of a unit/department. The Claims Processing Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. To be a Claims Processing Manager typically requires 5 years experience in the related area as an individual contributor. 1 - 3 years supervisory experience may be required. Extensive knowledge of the function and department processes. (Copyright 2024 Salary.com)

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Manager, Claims
  • AmTrust Financial
  • Irvine, CA FULL_TIME
  • Manager, Claims
    Job Locations US-CA-Irvine
    Requisition ID 2024-16419 Category Claims - Workers Compensation Position Type Regular Full-Time
    Overview

    AmTrust Financial Services, a fast growing commercial insurance company, has an immediate need for a Workers' Compensation Claims Manager in Irvine, CA. The Workers Compensation Claims Manager is responsible to supervise activities within the worker compensation lost time claims department. This may encompass supervision of administrative tasks and staff or oversight of the investigation of insurance claims involving workers compensation, property or casualty claims based on coverage, appraisal and verifiable injury or damage. This position involves the direct handling of tasks and/or claims in addition to supervision of staff. The WC Claims Manager reports to the WC Sr. Manager.

    Responsibilities
      May oversee the handling of all aspects of the claims assigned to the unit including reserving, communication, documentation, evaluation, negotiation and settlement
    • Ensures all claims eligible or ineligible for payment conform to quality, production standards, and specifications
    • Ensures claim processing is consistent with applicable policies, procedures and department guidelines
    • Analyzes and approves workers compensation claims
    • Completes regular quality audits of staffs work, records results and counsels staff to bring work to or above standards
    • Prepares regular periodic reports and monitors system reports to ensure adherence to corporate and regulatory standards
    • Establishes and executes controls to assure that the quality of the work meets or exceeds standards
    • Reviews and analyzes processes, procedures, and workflows to identify opportunities for process improvement and efficiency
    Qualifications
    • 10 years' experience in workers compensation insurance industry
    • Valid adjusters license in appropriate jurisdictions or ability to obtain such
    • Experience successfully managing claim professionals
    • Strong leadership skills
    • Ability to develop partnerships
    • Sound technical knowledge of workers' compensation policies, coverages, and exposures
    • Experience proactively managing catastrophic injuries
    • Ability to analyze data, and communicate trends
    • Ability to make essential decisions to positively impact change
    • Complete knowledge of claim procedures, technology, state and federal laws and insurance regulations
    • Superior written and verbal communication skills
    • Ability to mentor and encourage behaviors that impact claim performance
    • Professional demeanor and effective people skills
    • Ability to prioritize, and multi-task in team environment
    • Ability to travel

    The salary range for this role is $97,000 - $110,000/year. This range is only applicable for jobs to be performed in California. Base pay offered may vary depending on, but not limited to education, experience, skills, geographic location, travel requirements, sales or revenue-based metrics. This range may be modified in the future.

    #LI-NS1

    #LI-HYBRID

    What We Offer

    AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off.

    AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion or disabilities.

    AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative, enabling us to attract, retain and develop the best talent available. We see diversity as more than just policies and practices. It is an integral part of who we are as a company, how we operate and how we see our future.

    Connect With Us!
    Not ready to apply? Connect with us for general consideration.

     

  • 24 Days Ago

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CA - Orange County - 1099 Property Claims Adjuster
  • Copper Claims Services, Inc.
  • Irvine, CA 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...
  • 4 Days Ago

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Sterile processing manager
  • TalentMovers
  • Mission Viejo, CA FULL_TIME
  • HobDescription SterileProcessing / HLD personnel to assure all surgical trays are cleancomplete accurate and stored in designated areas. Refersperformance issues to the SPD Manager in a timely manner....
  • 9 Days Ago

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Loan Processing Manager
  • Summit Lending
  • Huntington, CA FULL_TIME
  • Company Overview:Amidst the challenges of the fluctuating mortgage market, our organization stands strong by focusing on HELOCs and Home Equity Loans. We are in search of a dedicated Mortgage Processi...
  • 10 Days Ago

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Claims Operations Group Manager
  • MS ACSC Management Services Inc
  • Costa Mesa, CA FULL_TIME
  • Claims Operations Group Manager This management leadership position is typically responsible for managing Claims Teams, or it can manage specialized functions within the Claims business unit. The prim...
  • 1 Day Ago

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Workers' Compensation Claims Manager
  • Zenith
  • Orange, CA FULL_TIME
  • A Brief Overview Responsible for the management of a branch claims office. Establishes goals, adheres to and supports corporate objectives, projects staff requirements, prepares budget, evaluates and ...
  • 18 Days Ago

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0 Claims Processing Manager jobs found in Orange, CA area

Orange is a city located in Orange County, California. It is approximately 3 miles (4.8 kilometers) north of the county seat, Santa Ana. Orange is unusual in this region because many of the homes in its Old Town District were built before 1920. While many other cities in the region demolished such houses in the 1960s, Orange decided to preserve them. The small city of Villa Park is surrounded by the city of Orange. The population was 139,812 as of 2014. The city has a total area of 25.2 square miles (65 km2), 24.8 square miles (64 km2) of which is land and 0.4 square miles (1.0 km2) of which i...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Processing Manager jobs
$105,608 to $136,401
Orange, California area prices
were up 3.0% from a year ago

Claims Processing Manager in Austin, TX
These claims management platforms are often not well integrated with peripheral systems, which also results in more human involvement and an increased cost per transaction.
January 26, 2020
Claims Processing Manager in Topeka, KS
The claims have to be handled timely to ensure quick settlement leading to customer satisfaction.
January 12, 2020
Managers can review workflow queues and see what is in each processor’s queue.
January 13, 2020
Claims Processing Manager in Youngstown, OH
A common duty in this position is reviewing insurance policies after clients have submitted claims, in order to determine coverage.
December 11, 2019