Vice President of Claims Adjudication
Confidential
Vice President of Claims Adjudication
About the Company
Premier cost-effective commercial insurance provider
Industry
Insurance
Type
Privately Held, VC-backed
Founded
2017
Employees
201-500
Funding
$200+ million
Categories
- Insurance
- Financial Services
- Insurance
- InsurTech
- Small and Medium Businesses
Specialties
- insurance
- insuretech
- workers' compensation
- and small business insurance
- small business insurance
- and commercial auto
About the Role
The Company is seeking a Vice President of Claims Adjudication to play a pivotal role in the design and execution of its claims strategy and programs. The successful candidate will be responsible for leading the claims adjudication function, with a focus on delivering optimal claim outcomes and exceptional customer experiences. This leadership role involves strategic planning, fostering relationships both internally and externally, and ensuring that the claims adjudication operations align with the broader claims strategy. The VP will also be accountable for the financial and performance aspects of the claims adjudication operation, driving continuous improvement, and leading innovation and technology initiatives to enhance the claims process. Applicants must have a minimum of 15 years' experience in workers' compensation claims, field claims operations, and claims adjudication, with at least 10 years in a people management role. The role requires an individual with a strong industry leadership track record, expert knowledge of managing disputed and litigated claims across multiple jurisdictions, and a data-driven approach to claims management. The ideal candidate will have a proven ability to contribute strategic insights, inspire and influence others, and foster a culture of open communication, continuous improvement, and innovation. Superior communication skills and the ability to represent the organization as a claims subject matter expert are essential. Experience in crisis communication and managing high-stakes stakeholder relationships is also a key requirement.
Hiring Manager Title
Chief Claims Officer
Functions
- Operations
Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Vice President of Claims Adjudication in Jacksonville, FL vacancy
- ...Vice President, Strategic Solutions & Delivery About the Company Innovative provider of cost containment technology & case management... ...responsibilities include serving as a thought leader in casualty operations, claims modernization, and AI-enabled business processes, as well as...Claims
- ...The Vice President, Operations leads the financial integration of new MGA and MGU programs across P&C and Consumer lines businesses. This... ...evaluation and onboarding of third-party vendors including TPA, claims, and technology providers. Ensure all SOX-relevant processes...ClaimsTemporary work
Fortegra
Jacksonville, FL2 days ago - ...Vice President of Engineering About the Company Innovative provider of personalized cancer education & navigation services Industry... ...-end workflows. While not mandatory, experience with medical claims, prior authorization, or other complex healthcare data is strongly...Claims
- ...Vice President of QA & Automation About the Company Large healthcare technology and services organization focused on enterprise quality... ...in healthcare technology, particularly in pharmacy, claims, or health-plan environments, and experience in applying automation...Claims
- ...Vice President of Sales About the Company AI-enabled healthcare revenue cycle management company serving complex medical billing and claims recovery. Industry Hospital & Health Care Type Privately Held About the Role The Company is seeking a Vice...Claims
- ...Vice President of Technology Operations About the Company Innovative healthcare technology (HealthTech) company specializing in prescription... ...Specialties optimized access to supplemental networks claim cost repricer healthcare cost containment pharmacy cost...Claims
- ...Vice President of Preconstruction About the Company Nationally recognized commercial construction organization with diverse projects... ...insurance structures, SDI programs, surety/bonding, and construction claims environments. Leadership characteristics include a...Claims
- ...Vice President of General Liability Claims About the Company Fast-growing organization providing innovative claims solutions Industry Insurance Type Privately Held, VC-backed Founded 2022 Employees 501-1000 Funding $26-$50 million Categories...Claims
- ...Senior Vice President, Benefits About the Company Global risk management firm helping clients navigate complex risks with creative solutions... ...specialty wholesale strategic risk analytics claims advocacy bermuda market access intermediaries group captives...Claims
- ...Vice President, Risk & Insurance About the Company Nationally recognized commercial construction organization with diverse portfolio... ...risk strategy, with a strong background in complex construction claims environments and a proven track record of managing...Claims
- ...Associate Vice President of Revenue Cycle About the Company Leading hospice, palliative & home health care provider Industry Hospital... ...staff, and ensuring the timely and accurate submission of claims across various payers. The role also requires close...Claims
- ...the Role Sedgwick is seeking a seasoned and highly effective Vice President, IT Internal Audit to help lead and advance the Company’s... ...this or other roles. Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating...ClaimsLocal areaRemote work
Sedgwick
Jacksonville, FL2 days ago - ...Duration: 6 months JD: Job TitleSenior Healthcare NASCO Claims Domain Specialist Insurance UAT Testing (Onsite)Job LocationOnsite... ...perspective.Ensure comprehensive validation of oClaims adjudication logicoPricing and repricingoAccumulators (deductibles, MOOP)oCOB...Claims
Real Soft
Jacksonville, FL4 days ago - ...Hybrid/Remote) Duration: 6 months Manage end-to-end short term disability claims process Act as mayor Evaluate medical and claim documentation for eligibility decisions Ensure timely adjudication and benefit payments Collaborate with clinical and vocational teams for case...ClaimsTemporary workRemote work
- ...Job Description Job Description Job Summary The Vice President, Complex Claims provides executive leadership for Fortegra's Complex Claims function, overseeing the handling, strategic direction, coverage analysis, litigation oversight, and resolution of the Company...ClaimsTemporary workLocal area
- ...Mental Health Resource Center, Inc. is seeking a Patient Accounts Specialist in Florida to handle accurate and timely insurance claims, reimbursements, adjustments, and refunds for assigned payers. The role requires a high school diploma and at least two years of medical...ClaimsFull timeWork at office
Mental Health Resource Center Inc
Jacksonville, FL1 day ago - ...fellowship training to eye-disease research and education. LOCATION :On site/Florida Eye Specialists Administration Office Job Summary: The Claims Analyst is responsible for reviewing, correcting, and resubmitting insurance claims to maximize reimbursement and ensure timely and...ClaimsWork at office
North Florida Surgeons, P.A.
Jacksonville, FL20 hours ago $70k - $90k
...ResponsibilitiesManage customer accounts and update information in the database.Assist customers with policy changes and inquiries.Process insurance claims and follow up with customers on claim status.Coordinate with underwriters to ensure timely policy issuance.QualificationsStrong...ClaimsFor contractorsWork at officeMichael Nickas - State Farm Agent
Jacksonville, FL2 days ago$45k - $65k
...Responsibilities:Manage client accounts and update information in the database.Assist clients with policy changes and inquiries.Process insurance claims and follow up with clients on claim status.Coordinate with underwriters to ensure timely policy issuance.Qualifications:Strong...ClaimsFor contractorsStephanie Lempesis - State Farm Agent
Jacksonville, FL1 day ago$44k - $50k
...Manage customer accounts and update information in the database.Assist customers with policy changes and inquiries.Process insurance claims and follow up with customers on claim status.Coordinate with underwriters to ensure timely policy issuance.Qualifications:Strong...ClaimsFor contractorsWork at officeBill Pool - State Farm Agent
Jacksonville, FL1 day ago- ...is seeking a Chief Operating Officer (COO) with a strong background in self-funded healthcare operations, stop-loss programs, and claims management. The successful candidate will be responsible for a combination of strategic and tactical activities to support the company...ClaimsRemote work
- ...and professionalism. What You Will Bring Experience ~5+ years of call center, contact center, BPO, customer service, claims, or operations leadership experience. ~2+ years leading supervisors, team managers, or frontline leaders. ~ Proven success managing...ClaimsLocal area
Solera, Inc.
Jacksonville, FL4 days ago - ...Vice President, Executive Search & Business Development About the Company Nationally recognized executive search firm Industry Staffing and Recruiting Type Privately Held Founded 1979 Employees 1-10 Categories Consulting & Professional...
$42k - $50k
...seeking an Accounts Receivable Specialist to resolve aged insurance receivables and recover revenue on denied, underpaid, and rejected claims. This position is a full-time, direct hire opportunity based in the greater Jacksonville, FL metro area. This role is best aligned...ClaimsHourly payFull timeContract workMonday to FridayTalentLNX
Jacksonville, FL1 day ago- ...Certified Professional Biller or Certified Coding Specialist). Experience working with private pay accounts and complex insurance claim resolutions. Familiarity with healthcare compliance regulations such as HIPAA and billing best practices. Advanced skills in...ClaimsWork at office
North Central Florida Sexual Assault Center
Jacksonville, FL4 days ago - ...rapport and relationships with community resources affiliated with home care services Organizational Relationship · Reports to President Special Requirements · Must have a car with required insurance coverage and a state driver's license or reliable...Local area
DDance Group Inc
Jacksonville, FL3 days ago $17 - $21 per hour
...Companies SNI Companies is looking for a Medical Biller. The ideal candidate will have prior experience in patient billing and medical claims/insurance management. This is a full-time position with remote flexibility. The Medical Biller is responsible for verifying patient...ClaimsFull timeWork at officeRemote workSNI Companies
Jacksonville, FL1 day ago$45k - $60k
...Manage customer accounts and update information in the database.Assist customers with policy changes and inquiries.Process insurance claims and follow up with customers on claim status.Coordinate with underwriters to ensure timely policy issuance.Qualifications:Strong...ClaimsFor contractorsWork at officeFlexible hoursTiffany Mapp - State Farm Agent
Jacksonville, FL1 day ago- ...Vice President of Medical Malpractice Insurance Underwriting About the Company Specializes in medical malpractice insurance underwriting... ...A minimum of 10 years' of commercial insurance underwriting, claims, product development, or related experience, and at least 8...
- VP Of Operations As the VP of Operations, you will own the operational P&L and execution strategy for our rapidly expanding QSR portfolio. Your primary objective is to drive Average Unit Volume (AUV) and EBITDA growth while overseeing the seamless integration of new...
Leap Brands
Jacksonville, FL1 day ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Vice President of Claims Adjudication. Be the first to apply!
Related searches
- vice president food Jacksonville, FL
- vice president support services Jacksonville, FL
- vice president network management Jacksonville, FL
- vice president real estate development Jacksonville, FL
- vp safety Jacksonville, FL
- vp talent management & organizational development Jacksonville, FL
- vice president manufacturing operations Jacksonville, FL
- vice president revenue management Jacksonville, FL
- vice president corporate development Jacksonville, FL
- vice president of customer success Jacksonville, FL