Managing Director, Strategic Claims Oversight, Healthcare Severity
Confidential
Managing Director, Strategic Claims Oversight, Healthcare Severity
About the Company
Top provider of insurance products & related services
Industry
Insurance
Type
Public Company
Founded
1897
Employees
5001-10,000
Categories
- Insurance
- B2B
- Enterprise
- Consulting & Professional Services
- Agents and Marketers
- Casualty
- Finance
- Multi-Line
- Property
- Property and Casualty Insurance
- Financial Services
- Information Technology
- Property Management
- Real Estate
- Risk Management
Specialties
- commercial insurance
- specialty insurance
- construction
- financial institutions
- healthcare
- manufacturing
- professional services
- real estate
- small business
- technology
- retail
- and wholesale distribution
Business Classifications
- B2B
- Enterprise
About the Role
The Company is seeking a Managing Director for Strategic Claims Oversight in Healthcare Severity. The successful candidate will lead a team that is responsible for the direct handling and oversight of the highest exposure claims in the healthcare sector. This role is pivotal in ensuring the effective execution of claims handling practices, driving operational initiatives, and leading continuous improvement efforts. The Managing Director will be accountable for the overall quality, customer service delivery, and productivity of the team, and will be expected to have a clear vision for their career, with the support of the company's leadership to help them achieve their professional goals. Key responsibilities for the Managing Director include leading and directing the work activities of the Severity Team, overseeing complex claim investigations, and determining claim strategies. The role also involves developing and maintaining collaborative relationships with internal and external business partners, and ensuring the team is in compliance with best practices. The ideal candidate will have a senior-level knowledge of claim and litigation management, excellent communication, negotiation, and facilitation skills, and the ability to manage ambiguous situations. A Bachelor's degree is required, with a JD preferred, and a minimum of ten years of claims or legal experience is typical, with a proven track record of positive results. The candidate should be value-driven, with a sense of urgency to advance the organization's priorities, and a strong ability to coach, mentor, and develop subordinate staff.
Hiring Manager Title
AVP
Functions
- Legal
- Operations
- ...Description Expanding Seaford based Law Firm seeking Representatives to verify payment status on Healthcare Providers outstanding 'Workers' Compensation Insurance claims. Candidates must have strong customer service and communication skills with the ability to navigate...Claims
$41.78k - $64.34k
...comprehensive appeals for denied or underpaid claims, including drafting compelling appeal... ...cycle processes, including denial management and follow-up.Conduct thorough follow-up... ...team member's base salary and/or rate, several factors may be considered as applicable...ClaimsHourly pay- ...Looking for a career with long-term growth potential in healthcare? We are currently seeking both experienced and entry-level... ...Opportunities may include: Medical Billing Revenue Cycle Management Insurance Claims Processing Medical Coding Healthcare Administration...ClaimsRemote jobFull timePart timeFor contractorsWork from homeFlexible hours
$65k - $85k
...State Farm agency in 2019 after spending several years working for State Farm Corporate, where... ...on our team. RESPONSIBILITIES: Manage customer accounts and update information... ...and inquiries. Process insurance claims and follow up with customers on claim status...ClaimsFor contractorsWork at officeLocal areaImmediate startFlexible hours- ...for Long Island. Be a part of our team of healthcare heroes and discover why Catholic Health... ...work appointments Telephone Calls Manage Incident reports and work place injuries... .... Assist with Workers Compensations Claims Return to work appointments/phone calls...ClaimsFlexible hours
- ...assist members, physicians, hospitals, and other healthcare providers with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals. This... ...functions and support projects as directed by the management. Balancing the demands of the caller with...ClaimsWork at officeRemote workFlexible hours
- ...Biller Position at Digestive Healthcare Associates The Biller plays a critical role in... ...healthcare and social assistance industry by managing the accurate and timely submission of... ...systems. Strong understanding of insurance claim processes, coding, and healthcare...ClaimsFull time
$65k - $85k
...State Farm agency in 2019 after spending several years working for State Farm Corporate, where... ...have you on our team. RESPONSIBILITIES Manage customer accounts and update information... ...and inquiries. Process insurance claims and follow up with customers on claim status...ClaimsFull timeWork at officeLocal area$24 - $26 per hour
...full-time Customer Service & Claims Processor Specialist role with... ...a background in dental or healthcare administration. Qualifications... ...healthcare and dental claims, manage data entry, and verify eligibility... ...candidate will be based on several factors including the...ClaimsHourly payPermanent employmentFull timeTemporary workWork experience placementCurrently hiringImmediate startShift work$50k - $60k
...Medical Collector is responsible for managing outstanding insurance and patient... ...billing discrepancies, appealing denied claims, and ensuring timely reimbursement while... ...solving skills and thrives in a fast-paced healthcare environment. Key Responsibilities...ClaimsFull timeWork at office$64k - $128k
...$128,000.00 Pay is based on several factors which vary based on position... ...experiences. By being a strategic partner for your peers and... ...experience of: ~ Creating and managing HR strategies and goals;... ...and compliance needs including claims management and return-to-work...ClaimsHourly payFull timeTemporary workWork experience placementLocal areaFlexible hoursShift workNight shiftDay shift- ...A leading training organization in Melville, New York, is seeking Licensed Claims Adjusters to join their team amid growing demand for insurance claims professionals. This role offers comprehensive training to equip both seasoned and new adjusters with the skills needed...ClaimsFlexible hours
$20 per hour
...ensure timely resolution of all outstanding claims, via phone, emails, fax or websites... ...patients, insurance payors, co-workers, management and clients Maintain confidentiality... ...following up on claims ~ Basic knowledge of healthcare claims processing including: ICD-9/10,...ClaimsHourly payWork at officeLocal area$75k - $80k
...Practice Manager Located in Commack, New York 11725 We're Looking... ...natural organizer with a heart for healthcare and a head for operations? Do... ...Making sure billing and claims are handled quickly and accurately... ...will be determined based on several factors, including the...ClaimsTemporary workWork at officeLocal areaHome officeFlexible hours- ...Service Client Specialist To The Managing Partner New York Life's General Offices are... ...development, recruiting initiatives, and strategic execution. The Service Client Specialist... ..., quality control, training, underwriting and claims Job Requisition ID: 94730...ClaimsFull timeWork at officeMonday to FridayFlexible hoursShift work
- ...institution providing education, healthcare & social justice services... ...systems with the organization's strategic and mission priorities, ensuring that resources are managed efficiently, transparently,... ...sustainably. This includes oversight of finance, HR, facilities, IT...
$24 - $30 per hour
...direction of the Hospital RRC Supervisor/ Manager, the Hospital Patient Financial Services... ...timely manner, and to document account/claim status and actions appropriately in the... ...terminology, CPT, HCPCS, and ICD10 coding used in healthcare. Ability to work independently,...ClaimsContract workWork at office$58.5k - $70.23k
...role, the successful candidate under the management of Credentialing Operations, Clinical... ...working in credentialing, managed care, or healthcare management or equivalent. Knowledge in... ...managed care and governmental contracting/claims processes preferred. Excellent computer...ClaimsFull timeContract work$150k - $180k
...Staff is to lead, develop and manage associate veterinarians in... ...veterinarian needs.\n Partner with the Director of Veterinary Quality and... ...to solve problems involving several variables.\n Requires... ...Spending Accounts (FSA): Save on healthcare and dependent care expenses by...Full timeTemporary workLocal areaFlexible hoursShift work$66.3k
...medicine and surgery. We are a major regional healthcare resource with a deep commitment to... ...and distribute orders; fill out damage claims and return orders; keeping daily records... ...years of relevant experience including managing office activities, and administering budgets...ClaimsFull timeWork at office$22 - $24 per hour
...profitable leading provider of innovative healthcare services including independent medical... ...bill reviews, Medicare compliance, case management, record retrieval, document management and... ...carriers, law firms, third-party claim administrators and government agencies that...ClaimsHourly payFull timeWork at officeMonday to Friday$350k - $425k
HealthCare Partners, IPA and HealthCare Partners, MSO together... ..., utilization management strategy, and care management oversight across the organization... ...physician oversight and strategic direction for Utilization... ...Partner with Medical Directors and operational leaders...Full timeWork at officeLocal area- ...Commercial Lines & Personal Lines Claims Consultant Job Location:... ...-Time Department: Claims Management Experience Required:... ...resolution. This position requires a strategic thinker who can navigate... ...Key ResponsibilitiesClaims Oversight and Management Oversee and...ClaimsFull time
- ...Candidate must be reliable and responsible. Should have ability to manage heavy phone intake and excellent communication skills. Dental... ...Verify dental insurance eligibility and assist with billing and claims processing Collect and post patient payments, co-pays, and maintain...Claims
- ...drug interactions and offering preventive healthcare services such as immunizations.... ...of the pharmacy and assists the pharmacy manager in identifying ways to optimize pharmacy... ...Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment...Hourly payInternshipLocal areaShift work
- A leading healthcare recruitment agency is looking for an Epic Physician Billing Analyst in Hicksville, New York. This role focuses on configuring... ...Billing module, ensuring accurate patient billing and claims processing. Candidates must hold a Bachelor's degree in a related...Claims
- ...experience handling professional liability claims Attorney with 2-5 years’ experience... ...legal analysis Strong work ethic, ability to manage caseload and work in a team environment Highly... ...limited to: Managing own caseload (with oversight by partners depending on experience level...ClaimsTemporary workWork at officeFlexible hours
$119.36k - $214.85k
...Clinical is responsible for managing the selection and... ...to ensure appropriate claims system set-up and... ...stakeholders (medical directors, pharmacists, nurses,... ...communities - and making healthcare simpler. We are a Fortune... ...week, and potentially several times per week....ClaimsTemporary workWork experience placementWork at officeLocal area2 days per week1 day per week$41.84 - $62.76 per hour
...responsible for overall management of member's case... ...Interfaces with Medical Directors, Physician Advisors and... ...solving with providers, claims or service issues.... ...communities - and making healthcare simpler. We are a Fortune... ...week, and potentially several times per week....ClaimsContract workTemporary workWork experience placementWork at officeLocal area1 day per week- ...theatre music dance honors healthcare and humanities About... ...front-line fundraiser and strategic leader, dedicating a... ...gift fundraising and actively managing a portfolio of high-capacity... ...involves providing executive oversight to advancement operations, including...
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