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
- ...Senior Vice President, Liability Operational Strategy About the Company Renowned provider of workers’ compensation & risk management... ...liability ~ general liability ~ ancillary benefit management ~ claims management ~ provider network ~ pharmacy benefit...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 Engineering About the Company Respected security & investigations company specializing in risk mitigation & investigative... ...utilization management case management bill review claims management osint medical canvassing and ai About...ClaimsRemote work
- ...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 Revenue Cycle About the Company Tech-enabled, multi-specialty medical practice delivering high-touch, data-driven... ...role includes evaluating and integrating modern technologies for claims processing, denial management, and payment analytics, while...Claims
- ...Vice President, Business Development, Life Sciences About the Company AI-driven healthcare analytics platform Industry Hospital... ...heor biotechnology real world evidence lab data and claims data Business Classifications SAAS B2B Enterprise...Claims
- ...Vice President of Gig Economy 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...ClaimsRemote work
- ...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, Medical Affairs About the Company Industry-shaping mobile application empowering employees to improve heart health... ...Responsibilities include translating evidence into clear, defensible market claims and commercial materials, supporting customer and partner...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
- ...Vice President of Medical Economics About the Company Healthcare organization focused on medical cost analytics and value-based care... ...performance strategy. The role oversees analysis of healthcare claims, utilization, risk, and provider performance to identify opportunities...Claims
- ...Vice President, Risk Management About the Company A leading farmer-owned agribusiness cooperative serving member-owners across a multistate... ...risk framework, insurance requirements, and all phases of the claims process. The VP will also be tasked with managing...ClaimsWork at office
- ...Vice President of Sales About the Company Leading organization specializing in claims management solutions Industry Hospital & Health Care Type Privately Held, VC-backed Founded 2006 Employees 1001-5000 Categories ~ Health Care Specialties...ClaimsContract workWork at office
- ...Vice President, Law Firm Professional Services About the Company Leading provider of a legal management software solution Industry... ...immigration legal document management legal billing claims litigation and in-house legal Business Classifications...Claims
- ...Vice President of Product, Interoperability About the Company Globally-recognized payment integrity & transaction analytics company... ...subject matter expertise in payer/provider interoperability and claims processing operations is essential, with a strong preference for...ClaimsContract work
$125k - $140k
...Description Vice President of Finance Humane Society for Southwest Washington | Vancouver, Washington Reports to: President Status... ...insurance coverage, broker relationships, renewals, and claims coordination; assess coverage needs and risks with the President...ClaimsFull timeContract workCasual workFlexible hoursAfternoon shift- ...Vice President of Commercial Strategy About the Company Innovative healthcare technology (HealthTech) company providing cloud-based... ...Insurance Specialties clinical and quality outcomes claims and payment integrity healthcare data insights predictive...Claims
- ...Associate Vice President, Workers' Compensation Claims About the Company Leading insurance carrier hiring for senior workers' compensation claims leadership Industry Insurance Type Privately Held About the Role The Company is seeking an Associate...Claims
- ...Vice President & Associate General Counsel, Litigation About the Company Well-recognized operator of hospitals, nursing centers & other... ..., and court proceedings. The role also oversees liability claims, settlement recommendations, legal reserves, litigation reporting...Claims
- ...Vice President of People About the Company AI-driven infrastructure for payers, providers & value-based care organizations Industry... ...consulting predictive modeling data management adjudication neutral-arbitrator value-based contract adjudication...Contract work
- A leading claims adjusting firm located in Oregon is seeking Independent Insurance Claims Adjusters to support individuals recovering from disasters. This is a unique opportunity for those seeking a dynamic career path with flexible hours and competitive pay. The firm...ClaimsFlexible hours
- ...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...
$22 - $25 per hour
...would love to consider you! Thank you for considering our team as your new work family! Job Duties and Responsibilities: Claims submission; both electronic claims submission and manual Contact insurance companies regarding denied claims Contact insurance...ClaimsHourly payFull timeWork at office- An insurance adjusting firm in Oregon is seeking Licensed Claims Adjusters to fill urgent positions. This opportunity offers comprehensive training and support for newcomers while attracting seasoned professionals. You'll play a vital role in disaster recovery, with the...ClaimsImmediate start
- A national insurance claims company is seeking Independent Claims Adjusters to thrive in a rewarding career. This role includes assessing claims, helping clients recover from disasters, and flexibility in your work schedule. Previous experience is a plus, but not required...Claims
- A prominent claims adjusting firm is actively seeking Licensed Claims Adjusters in Vancouver, Washington. As an Independent Insurance Claims Adjuster, you will assist clients in recovering from disasters while enjoying the benefits of a flexible and rewarding career. The...ClaimsFlexible hours
$176.9k - $239.34k
...including prior authorization, appeals/denials, coding, billing, claims, benefit design, and patient support programs, with the... ...specialty pharmacy, HUB services, insurance verification, claim adjudication, or pharmaceutical/biotechnology manufacturers.Previous experience...ClaimsFull timeWork at officeLocal areaRemote workWork from homeFlexible hours- ...providers. Duties: Review and enter medical codes for procedures, diagnoses, and services Prepare and submit insurance claims accurately and timely Verify patient insurance information and benefits eligibility Maintain patient records and update electronic...ClaimsTemporary workWork at office
- ...transactions. Discuss financing options, including CareCredit , when appropriate. Assist patients with insurance documentation and claim information. Maintain accurate patient records and documentation. Follow up with prospective patients and encourage scheduling...ClaimsWork at office
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