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
$171.6k - $338.3k
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- ...fastest growing companies. We are currently recruiting for a Vice President of Accounting who is responsible for providing strategic... ...professionalliability and cyber policies. Manage renewals, claims, and broker relationships to ensureadequate coverage and competitive...ClaimsLocal areaRemote work
- ...tasks in order to recognize the maximum reimbursement from each claim. This position will be responsible for navigating the... ...and construct responses to insurance carriers based on claim adjudication. Follow up with payers and other appropriate parties to collect...ClaimsWork at office
$50k
...a hospital setting. Ensures accurate and timely submission of claims, works to resolve outstanding balances, and communicates effectively... ...or by contacting third-party payers or guarantors Review adjudicated claims from Medicare, Medicaid, and commercial carriers for...ClaimsBank staffFlexible hours$20 per hour
...Job Description Job Description Position Title: Claims Specialist Location: Schertz, TX (On-Site Monday-Friday) Position... ...for coverage for all relevant claims. Responsible for the claim adjudication process that includes the interpretation of warranty and service...ClaimsHourly payFull timeMonday to FridayFlexible hoursNight shiftWeekend work$225k - $375k
...maintaining appropriate market responsiveness and local accountabilityCreate effective interfaces with national support teams for claims, payment integrity, utilization and care management, call center operations, credentialing, technology, data and digital enablementDeliver...ClaimsMinimum wageFull timeWork experience placementLocal area- ...Job Description Our client is seeking a Claims Training Project Manager to support a Claims Technical Training Center. This hands-on role will coordinate project activities, meetings, training content, and stakeholder communications while partnering with claims SMEs...Claims
$85.04k - $162.55k
...policy and business needs. The Opportunity As a dedicated Injury Claims Examiner (Central to West regions), you will be responsible to... ...liability, investigating, evaluating, negotiating, and adjudicating claims in compliance with state laws and regulations. Responsible...ClaimsContract workH1bWork at officeRemote work3 days per week- ...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
- ...Duties Advises on claims laws for the DHA command on legal issues Conducts legal research, analyzes judicial decisions, and... ...legislation, regulations, and directives for legal sufficiency Adjudicates medical billing compromises, discounts, and waivers...Claims
$1,000 per month
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$40k - $60k
...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...ClaimsFor contractorsWork at office$50k
This position has two components: the Vice President for Presidential Initiatives and the Chief of Staff to the President. The position is a Cabinet-level position. The primary work location is at the executive offices at the Academic Campus of UT San Antonio.The Vice...Temporary workBank staffWork at officeFlexible hours- ...of benefits (EOBs), and manual checks from insurance payers and patients. • Denial & Adjustment Tracking: Identify, code, and log claim denials, line-item adjustments, and contractual write-offs to route zero-paid or underpaid claims for immediate appeal. • Account...ClaimsImmediate start
- ...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...
- ...established and growing law firm is seeking a skilled and dedicated attorney with significant experience in first-party homeowner property claims to join its dynamic team. The ideal candidate will bring a strong background in representing policyholders in disputes with...ClaimsFull timeRelocation package
- ...Specialist to manage all aspects of medical AR collections for a physician medical group. This role will focus heavily on insurance claim denial follow-up, unpaid claims, payment recovery, billing issue resolution, and account management. Key Responsibilities Manage...Claims
- ...established and growing law firm is seeking a skilled and dedicated attorney with significant experience in first-party homeowner property claims to join its dynamic team. The ideal candidate will bring a strong background in representing policyholders in disputes with...ClaimsFull timeRelocation package
$50k - $70k
...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...ClaimsFor contractors$19 per hour
...Reimbursement Specialist to join our healthcare team. The ideal candidate will be responsible for managing and processing medical claims, ensuring accurate reimbursement from insurance providers, and maintaining compliance with healthcare regulations. This role requires...ClaimsFull timeWork at office
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