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
$175.3k - $322.9k
...insurers deliver better customer experience while enabling claim professionals to adjudicate claims more effectively and accurately. This is a great... ...shape and improve the products in the portfolio. The Vice President, Sales Executive requires a commercially driven...ClaimsLocal area$25 per hour
...We are seeking a Pharmacy Adjudication Specialist for our Specialty Oncology pharmacy. As our company continues to grow, we strive to... ...The Pharmacy Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy. ensure prescription claims...ClaimsFull timeTemporary workWork experience placementRemote workRelocation packageFlexible hoursShift work$50 per hour
This OpportunityWSP is currently initiating a search for a Vice President, Construction Management engineer for our Indianapolis, IN office... ...project deliverables for clients such as constructability reviews, claims analysis, contract document drafting, and other related...ClaimsContract workWork at officeLocal areaFlexible hours- ...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
$201k - $294.8k
...subcontractor performance, change-order discipline, RFI resolution, earned-value verification, and independent challenge of contractor claims, in coordination with Project Controls.Lead construction workforce strategy across union and non-union environments, including site...ClaimsFor contractorsFor subcontractorRemote workFlexible hours- ...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
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- ...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 Artificial Intelligence & Machine Learning About the Company A healthcare technology startup helping providers get paid by rapidly remediating denied claims. Industry Information Technology and Services Type Privately Held, VC-backed...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
- ...Vice President, Health Plan Analytics About the Company Prominent healthcare system Industry Hospital & Health Care Type... ...as HEDIS, Medicare Stars, and CAHPS, as well as experience in claims analytics, total cost of care reporting, and provider network...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
- ...Assistant Vice President, Claims – Complex Casualty About the Company Highly profitable mutual insurance company with best-in-class claims service. Industry Insurance Type Privately Held About the Role The Company is seeking an Assistant Vice President...ClaimsRemote work
$229.5k - $336.6k
...requirements, U.S. and global clinical development and regulatory submissions, the Anti-Kickback Statute and its safe harbors, the False Claims Act, antitrust and unfair competition law, consumer protection, data rights and privacy, FTC commercial law, and business...ClaimsFull timeFixed term contractRemote workWorldwideFlexible hours- ...decisions and maintains a visible external presence with agents, brokers, and industry stakeholders. Partners closely with actuarial, claims, product, distribution, and technology teams to ensure the specialty portfolio is well-positioned, well-priced, and well-run.Key...ClaimsTemporary workLocal area
- ...expert in order to maintain and advance its health insurance claims processing system, ACAPS. The EDI Expert is responsible for... ...from health providers at , are loaded into our database, are adjudicated based on state and national pricing standards, and as adjudication...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
- ...they need to grow throughout their journey. Job Summary: The Claims Manager is responsible for overseeing the end-to-end handling... ...insurance claims processes, policy interpretation, and claims adjudication · Excellent negotiation and conflict-resolution skills ·...ClaimsWork at officeLocal area
- ...pm Responsible for processing customer bills and insurance claims in an accurate and timely manner. This includes assisting with... ...documentation in timely manner. Perform prescription claims adjudication including communication with insurance companies regarding...ClaimsFull timeTemporary workWork at officeFlexible hours
$48k - $55k
Overview To provide Absence case management and claim adjudications, based on medical documentation and the applicable Disability/FMLA/Paid Family Leave interpretation, including determining benefits due and making timely payments and adjustments. Responsibilities To...ClaimsTemporary work- ...A well-established claims adjusting firm in Fishers, Indiana, is seeking Independent Insurance Claims Adjusters to fill urgent roles in a rapidly growing industry. As a claims adjuster, you will assist diverse clients in managing the aftermath of disasters and help them...Claims
- ...depositions, hearings, mediations, and trial preparation Maintain and track case deadlines, court dates, and attorney calendars Investigate claims and document findings in Filevine Verify and communicate with insurance carriers regarding coverage and claims Track and manage...ClaimsWork at office
- ...Addison Group is hiring Insurance Collections Specialists for a fully remote role. The position focuses on insurance accounts receivable, claim resolution, and reimbursement optimization within a healthcare revenue cycle environment. Strong emphasis on resolving claims with...ClaimsRemote work
- ...developmental in nature. Review and validate military out-of-service claims and a small number of civilian claims. This involves... ...and pay information. Prepare payment vouchers after claim adjudication. Reconstruct and correct the appropriate pay systems (DJMS and...Claims
- ...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
- A national claims adjusting company is seeking Independent Insurance Claims Adjusters to join their team in Greenwood, Indiana. This opportunity allows for flexible work and requires a Licensed Claims Adjuster. The role involves helping clients recover from disasters and...ClaimsFlexible hours
- ...Head of Claims About the Company Growing specialty insurance organization focused on claims strategy and operational excellence. Industry Insurance Type Privately Held About the Role The Company is seeking a Head of Claims to take on a senior leadership...Claims
- ...department invoices.Assists internal customers with general contract reviews, insurance certificate requests, proof of insurance, claims questions.Coordinates and Manage Certificates of Insurance and Auto ID Cards requests.Reports and manages Property Insurance Claims...ClaimsFull timeContract work
$60k - $85k
...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
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