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, Head of Claims Intake About the Company Insurance claims operations leader focused on efficient intake, reporting, and client relations. Industry Insurance Type Privately Held About the Role The Company is seeking an SVP,...Claims
- ...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
$211.25k - $357.5k
...The Standard. Partner with cross-functional teams in actuarial, compliance, legal client management, IT, Strategy, AI Applications, Claims and Customer Service. Growth and Sustainability: Innovate and implement tools and processes that improve efficiency and compliance...ClaimsFull timeContract workLocal areaRemote work- ...Vice President of Reinsurance Operations About the Company Nationally recognized insurance company Industry Insurance Type... ...operational leadership in areas such as treaty administration, claims handling, accounting and reporting, and reinsurance analytics....ClaimsContract work
- ...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 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
- ...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, Health Economics About the Company Acclaimed provider of employer-based health services Industry Health, Wellness... ...of a function dedicated to translating clinical and claims data into actionable insights. The successful candidate will be...Claims
- ...Associate Vice President, Commutations About the Company Globally recognized insurance group specializing in innovative capital release... ...and reinsurance, with a preference for a background in claims. The role requires a high level of autonomy, strong communication...Claims
- ...Finance team, the Billing Specialist will be accountable for the claim balance of specifically assigned accounts. Duties will include... ...companies to identify and solve issues, resubmitting and adjudicating denied and rejected claims, and applying payments as needed within...ClaimsWork at officeRemote work
- ...Work® Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Workers Compensation | Jurisdiction: OR | Licensing:... ...? Apply your workers compensation knowledge and experience to adjudicate complex customer claims in the context of an energetic culture....ClaimsWork at officeLocal areaWork from homeFlexible hours
- ...Acuity Insurance is seeking a Field Claims Representative to investigate, record facts, preserve evidence, and determine coverage. This role requires conducting investigations in the field with a high level of frequency and in-person contact with all pertinent parties...Claims
- ...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
- ...ZoomCare is seeking an Insurance Follow Up Specialist to join our team in Oregon. This role focuses on resolving outstanding insurance claims to maximize reimbursement and reduce accounts receivable days, through researching denials, communicating with payers, and...Claims
- ...Portland, Oregon. In this role, you will be responsible for entering charges, auditing authorizations, and resolving denied insurance claims. We offer a supportive environment where every team member is valued. If you are passionate about contributing to the well-being of...Claims
$297.86k
Responsibilities The Vice President / Chief Pharmacy Officer provides strategic and operational leadership to the Pharmacy Enterprise across all Legacy Health System sites. Responsible for developing and maintaining integrated high quality pharmacy services across Legacy...- 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
- 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
$23 - $29 per hour
...Specialist is responsible for resolving outstanding insurance claims to maximize reimbursement and reduce accounts receivable days.... ...documentation, or demographic information to facilitate proper adjudication. Maintain thorough and accurate records of all claim follow...ClaimsHourly payWork at officeRemote workMonday to FridayFlexible hoursShift work3 days per week- 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
- ...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
- ...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...
- ...both patients and providers.Duties:Review and enter medical codes for procedures, diagnoses, and servicesPrepare and submit insurance claims accurately and timelyVerify patient insurance information and benefits eligibilityMaintain patient records and update electronic...ClaimsWork at office
- ...excellence (e.g., member of a working team). Models effective collaboration across teams, stakeholders and partners (e.g., UW Support, Claims, Actuarial, Directors of Underwriting in North America). Has strong knowledge of key legal cases, legislation and regulation...ClaimsLocal area
- ...a growing healthcare team. The ideal candidate will have strong knowledge of medical terminology, coding guidelines, and insurance claim procedures. This role is responsible for accurately reviewing and assigning appropriate medical codes to patient records to ensure proper...ClaimsTemporary workStart working today
$52k - $75k
...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...Claims$65k - $75k
...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. Strong...ClaimsFor contractorsWork at office- Liberty Mutual Insurance in Lake Oswego, OR, is seeking a Commercial Insurance Claims Representative to review and process simple to moderate claims within authority. The role supports a hybrid work model with in-office visits twice a month for candidates living within...ClaimsWork at office
$72.5k - $108.8k
...liability determination, and management of long-term disability claims. The Senior Case Manager I, LTD acts independently and... ...physician, etc.) to gather pertinent data to analyze the claim Adjudicates claims accurately and fairly in accordance with the contract,...ClaimsContract workWork experience placementWork at officeLocal areaFlexible hours2 days per week- ...issues management.Reporting directly to the Chief Public Affairs Officer and maintaining a dotted-line relationship to the Regional President, this leader serves as the primary Public Affairs advisor to Market leadership and operates at the intersection of enterprise...Local areaShift work
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