Regional Claims Manager jobs in Lawrence, MA

Regional Claims Manager manages the operations of an insurance claims department to meet operational, financial, and service requirements. Oversees the intake and processing of insurance claims for personal, property, or casualty loss based on coverage, appraisal, and verifiable damage. Being a Regional Claims Manager manages appraisal and examination staff and processes. Assures timely and proper disposition of claims based on policy provisions. Additionally, Regional Claims Manager recommends and implements best practices to ensure complete and thorough claim settlements, legal reviews, and investigations following company policies and insurance industry regulations. Determines the value of settlements for escalated claims. Manages negotiations of settlements and administration of claims in litigation. Typically requires a bachelor's degree. Typically reports to top management. The Regional Claims Manager typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. To be a Regional Claims Manager typically requires 3+ years of managerial experience. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. (Copyright 2024 Salary.com)

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Claims Manager
  • Jencap
  • Danvers, MA FULL_TIME
  • Why Jencap? We are one of the largest wholesale insurance intermediaries in the United States with expertise in wholesale brokerage, binding authority, and program management. The common thread woven throughout our success story is our collaborative and driven team of people. Our teams are empowered and work together to find solutions. We have a passion culture – with teamwork, collaboration and a focus on growing individuals and giving them the tools & development opportunities to have a successful career. 

    HRMP, a Jencap company, is a third-party administrator for risk takers and is uniquely positioned to offer business solutions to carriers, reinsurers, and underwriters. We provide a variety of services and solutions within the insurance market such as stop-loss program administration, group life and medical conversions, auditing services, back office or run-out administration, quota share and excess medical reinsurance. 

    The Claims Manager supports medical insurance customers (including administrators, MGUS, brokers) by confirming eligibility, determining insurance coverage, examining and resolving medical stop loss claims, documenting actions, maintaining quality customer service, ensuring compliance.

    This role will work a hybrid schedule reporting to our Jencap office in Danvers, MA. 

    Responsibilities: 

    • Establishes proof of loss by reviewing medical documentation presented, requesting additional information from sources such as (administrator, broker, hospital, physician etc.)
    • Adjudicates claims in medical stop loss system (ESL) and or (UGAN) approving, denying based on compliance with SPD and Stop loss policy.
    • Reports to client regarding reimbursements and in turn forwards to accounting department for reimbursement
    • Maintains quality client service by responding timely and accurately to client inquiries maintaining client expected turn-around time
    • Prepares standard and ad hoc reports
    • Maintains confidentiality and comply with Health Insurance Portability and Accountability Act  (HIPAA)

    Requirements:  

    • College degree or a minimum of five (5) years medical stop loss claims processing.  
    • Strong written and verbal communication skills.
    • Working knowledge of David Young (ESL System) and or Kevin Ugan system.
    • Flexibility to handle multiple priorities while maintaining high level of professionalism.
    • Must be able to work well independently or in a team environment. 
    • Knowledge of CPT/HCPC, Revenue and ICD9 to ICD10 coding procedures and guidelines

    Want the opportunity to build something new? Expand your knowledge and stretch your experience through new and emerging risks? Have your voice heard, your skills properly applied, and to add tangible value to an organization? You’re in the right place. 

    Jencap is dynamic, bold, tenacious, and trusted in the industry. Here, you are not just one of the many, you are one of us.  We truly are better together. 

    The base salary offered for the successful candidate will be based on compensable factors such as job-relevant education, job-relevant experience, training, licensure, demonstrated competencies, geographic location, and other factors. The base pay range for the Claims Manager will be $95,000 . Discretionary incentive compensation may be awarded. Jencap also offers a range of benefits and programs, based on eligibility, which currently include but are not limited to; comprehensive health care coverage, a 401k plan, and tuition reimbursement.  Jencap is an emerging and rapidly growing leader in the industry and as such, we approach talent acquisition as an opportunity to identify the best talent. Therefore, the level of the role and compensation may vary depending upon the best available candidate. 

    Jencap is an Equal Opportunity Employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin or citizenship status, sexual orientation, gender identity or expression, pregnancy, marital or familial status, disability status, medical condition, genetic information, military or veteran status, political affiliation, or any other characteristic protected by law. We are committed to fostering a work community where every colleague feels welcomed, valued, respected and heard, as we believe that that creating an environment where every employee feels included and empowered, helps us to deliver the best outcome to our clients. 

     

  • 23 Days Ago

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Claims Manager - REMOTE
  • Jencap
  • Danvers, MA FULL_TIME
  • Why Jencap? We are one of the largest wholesale insurance intermediaries in the United States with expertise in wholesale brokerage, binding authority, and program management. The common thread woven ...
  • 14 Days Ago

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Regional Manager
  • American Technologies Inc.
  • Salem, NH FULL_TIME
  • ATI Restoration, LLC. (ATI)—a national leader in restoration, environmental remediation and reconstruction—is seeking a Regional Manager to manage its Salem, NH office and drive the overall market str...
  • 1 Month Ago

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Special Eductiona Case Manager/Teacher
  • Sanborn Regional School District
  • Kingston, NH FULL_TIME
  • DO NOT APPLY ON SCHOOLSPRING Please apply at www.sau17.org/employment Description: Memorial Elementary School seeks a highly qualified and dynamic educator to join our Special Education team for the 2...
  • 7 Days Ago

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Special Eductiona Case Manager/Teacher
  • Sanborn Regional School District
  • Kingston, NH FULL_TIME
  • DO NOT APPLY ON SCHOOLSPRING Please apply at www.sau17.org/employment Description: Memorial Elementary School seeks a highly qualified and dynamic educator to join our Special Education team for the 2...
  • 7 Days Ago

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Regional Operations Manager
  • Glevum Security Limited
  • Gloucester, MA FULL_TIME
  • Regional Operations Manager (Security Services) Salary: £38,000 – £42,000 Location: Gloucester. To meet company growth plans, we are seeking to recruit an ambitious quality focused Regional Operations...
  • Just Posted

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0 Regional Claims Manager jobs found in Lawrence, MA area

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Director of Large Loss Complex Claims, Homeowners Insurance
  • Plymouth Rock Assurance
  • Boston, MA
  • The Plymouth Rock Home team is an innovative Insurtech start-up within a successful, well-established insurance organiza...
  • 4/25/2024 12:00:00 AM

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Casualty Claims Director
  • Plymouth Rock Assurance
  • Boston, MA
  • Reporting directly to the Vice President of Claims of the Independent Agent Channel, the Director will oversee our MA an...
  • 4/25/2024 12:00:00 AM

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Expert Consultant, P&C Insurance
  • Boston Consulting Group
  • Boston, MA
  • Who We Are Boston Consulting Group partners with leaders in business and society to tackle their most important challeng...
  • 4/25/2024 12:00:00 AM

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CASUALTY CLAIMS MANAGER
  • Hp Hood Llc
  • Lynnfield, MA
  • MA, Lynnfield, HPHLynnfield, MA 01940, USADescription Are you a self-driven person looking to advance your career as a h...
  • 4/24/2024 12:00:00 AM

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Claims Settlement Specialist
  • Zelis
  • Boston, MA
  • Position Overview The Claims Settlement Specialist supports claim settlement with providers through post payment negotia...
  • 4/24/2024 12:00:00 AM

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Personal Lines Account Executive
  • World Insurance Associates LLC
  • Danvers, MA
  • Summary World Insurance Associates is a unique insurance organization offering top products and services from major prov...
  • 4/23/2024 12:00:00 AM

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Director, Insurance Risk
  • Fidelity TalentSource LLC
  • Boston, MA
  • Job Description: Based within the Treasury Risk and Insurance team in Corporate Treasury, this role serves as a resource...
  • 4/22/2024 12:00:00 AM

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Customer Service Account Manager (sales/insurance experience ideal!)
  • J. M. Whitney and Co.
  • Watertown, MA
  • Job Description Job Description We currently need a customer service manager who will be responsible for handling our cu...
  • 4/21/2024 12:00:00 AM

According to the United States Census Bureau, the city has a total area of 7.4 square miles (19 km2), of which 7.0 square miles (18 km2) is land and 0.4 square miles (1.0 km2) (6.07%) is water. Lawrence is on both sides of the Merrimack River, approximately 26 miles (42 km) upstream from the Atlantic Ocean. On the north side of the river, it is surrounded by Methuen. On the south side of the river, the town is bordered by North Andover to the east, and Andover to the south and southwest. Lawrence is approximately 30 miles (48 km) north-northwest of Boston and 27 miles (43 km) southeast of Manc...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Regional Claims Manager jobs
$171,238 to $239,824
Lawrence, Massachusetts area prices
were up 1.6% from a year ago

Regional Claims Manager in Tucson, AZ
As a Regional Contract Claims Manager, located in our Broomfield, CO office, you will have responsibility for claims management within your assigned region.
December 13, 2019
Regional Claims Manager in Las Cruces, NM
Paul Martin of Colorado seek an unspecified amount of damages against defendants Shelly Reams, former administrator of the Wyoming Aeronautics Commission; members of the Cheyenne Regional Airport Board; Dave Haring, manager of the Cheyenne airport; and Great Lakes Aviation.
February 18, 2020
Regional Claims Manager in Passaic, NJ
Aligning performance of regional teams, to support delivery of the wider Third-Party Claims Targets & Objectives.
January 16, 2020