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
$97k - $189k
...employees are used to their fullest potential. The Managing Director Strategic Claim Oversight leads the Severity & Excess Accounts team that both directly handles and oversees the highest exposure claims in Healthcare. Ensures the effective execution of claims handling...ClaimsFull timeWork experience placementWork at office- ...recommends improvements for financial management of each billing area.... ...analysis • Insurance claim adjudication knowledge • Commercial... ...• Knowledge of HIPAA and healthcare compliance requirements Remote... ...'s base salary and/or rate, several factors may be considered as...ClaimsHourly payContract workWork at officeRemote workMonday to Friday
$72k - $141k
...seeking a Complex Claims Consultant in our... ...primarily focus on high severity D&O and E&O claims... ...guidelines:Manages an inventory of highly... ...to include on oversight list, and preparing... ...RelationshipTypically Director or aboveSkills,... ...resolution strategies and strategic coordination with...ClaimsFull timeWork experience placementWork at officeLocal areaShift work$194k - $308k
CNA Insurance in Melville, NY is seeking an Officer to oversee loss cost management and major case oversight in Workers Compensation. This strategic role focuses on driving claim management efficiencies and aligning with corporate objectives. The ideal candidate will have...Claims$116k - $165k
...leader in insuring Allied Healthcare Providers, including... ...focused Complex Claims Consultant position, you... ...overall investigation, management and resolution of Allied... ...claims to include on oversight/watch lists, and preparing... ...RelationshipTypically Director or aboveSkills,...ClaimsFull timeWork experience placementWork at officeLocal areaFlexible hoursShift work$24 per hour
...ready to leverage your background in healthcare billing and data management into a dynamic, high-growth... ...experience in medical collections, medical claims, revenue cycle management, or third-... ...successful candidate will be based on several factors including the candidate's...ClaimsHourly payPermanent employmentTemporary workWork experience placementImmediate startShift work- ...Payment CollectorAre you ready to leverage your background in healthcare billing and data management into a dynamic, high-growth environment? A Healthcare... ...with experience in medical collections, medical claims, revenue cycle management, or third-party claims processing...Claims
- ...patient accounts, resolves billing discrepancies, and appeals denied claims to ensure timely reimbursement with strong customer service.... ...billing or collections, solid analytical and communication skills, and thrives in a fast-paced healthcare environment. #J-18808-Ljbffr...Claims
- ...Casualty Litigation Manager (Liability & Insurance... ...Omaha, NE Department: Claims & Legal Company:... ...a passion for driving strategic outcomes, we'd love to... ...management and legal spend oversight. Analyze litigation... ...complex, high-severity claim and litigation exposures...ClaimsWork at office
- ...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
- ...Health Plan is seeking a Contracting Systems Manager to translate contract terms into system... ...contract-to-system alignment across IT, Claims, Finance, and Provider Operations to... ...requires deep contracting experience, testing oversight, and strong collaboration across...ClaimsRemote jobContract work
- ...assist members, physicians, hospitals, and other healthcare providers with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals. Primary... ...and support projects as directed by the management. Balancing the demands of the caller with program...ClaimsWork at officeFlexible hours
$100k
...regional partners, and the Director of AR Operations.This... ...denied and underpaid claims in a timely and... ...resources are effectively managed to support high-quality... ...with healthcare billing practices and... ...hospital care including several named "Best Of" by US...ClaimsTemporary workWork at office$147k - $241.5k
...potential. Leads a team of Claims Consultants and Consulting Directors that are responsible... ...effective team management and the resolution of... ...activities of medium to high severity specialized Claims... ...and retention.Provides oversight and strategic direction on claim files...ClaimsFull timeWork experience placementWork at officeLocal area$99k - $232k
...member’s unique strengths, and managing performance to deliver on... ...learning techniques to large-scale claims, clinical, and member data to... ...client accounts, focusing on strategic planning and mentoring junior... ...a significant impact in healthcare.Responsibilities- Apply advanced...ClaimsFull timeH1b$110k - $160k
...Island. Be a part of our team of healthcare heroes and discover why... ...Workplace! Job Details The Risk Manager conducts comprehensive... ...risk reduction initiatives and strategic clinical safety metrics. Actively... ...and potential patient claims. Conduct complete investigations...Claims- ...clinical services, provide administrative oversight and manage quality and safety performance metrics... ...as we work together to transform healthcare. We encourage all team members to actively... ...Hospital among the country's best in several pediatric specialties. The Icahn...Full timeTraineeshipLive inLocal area
- ...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
- ...is looking to independently manage complex litigation matters, mentor... ..., and General Liability claims. Handle all phases of litigation... ...limited administrative oversight. Appear in state and local... ...While we originally focused on healthcare staffing, we’ve expanded into...ClaimsWork at officeLocal areaRelocation package
- ...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...
- ...ensure timely resolution of all outstanding claims, via phone, emails, fax or... ...patients, insurance payors, co-workers, management and clientsMaintain confidentiality at all... ...following up on claimsBasic knowledge of healthcare claims processing including: ICD-9/10, CPT...ClaimsWork at officeLocal area
$8 per hour
...PracticeQ and Google Calendar. Manage weekly meetings, including... ...with EOB checks and weekly claims reviews. Identify missing... ...support, care coordination, or healthcare administration. Experience... .... Able to manage several workflows while staying organized...ClaimsFull timeWork at officeRemote workShift work$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$99k - $232k
...leveraging team member’s unique strengths, and managing performance to deliver on client... ...back office operations- Specialization in claims, enrollment, billing, and membership-... ...Experience with transaction lifecycles and Healthcare/Payer Services- Knowledge of COTS...ClaimsFull timeH1b- ...and success of Travelers.What Will You Do?Manage the profitability, growth, and retention... ...and frequently partner with your Managing Director (MD) to develop region/group sales plans.... ...a Must Have?Four years of underwriting, claim, operations, risk assessment, actuarial,...ClaimsFull timeLocal area
- ...The Role The Medical Director will be responsible in... ...of their member’s claims. Your interest and help... ...service, support of quality healthcare service, and medical... ...expert for care management and population health;... ...base salary and/or rate, several factors may be considered...ClaimsHourly payWork at officeLocal areaFlexible hours
- ...Lead revenue cycle strategy at a healthcare organization, driving impactful... ....Develop and implement strategic initiatives to maximize collections... ...multiple healthcare locations.Monitor claim submissions, payment postings, and denial management workflows to ensure operational...Claims
- ...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
$72k - $141k
...supported in using their talents to their fullest potential. This individual contributor role operates under broad authority to manage commercial claims of high complexity and exposure within the Commercial Auto/General Liability/ Construction Auto and General Liability line...ClaimsFull timeWork experience placementWork at officeFlexible hours$66.3k - $73.46k
...surgery. We are a major regional healthcare resource with a deep... ...candidate is responsible for managing diverse and confidential projects... ...to support department director and/or manager. Answers requests... .... May have budget oversight as directed. Monitors supply...Full timeWork at officeImmediate start
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