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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$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, 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
$300k
...About the Position The company is seeking two newly created Vice President of Operations roles, one focused on public-sector work, one on... ...contracts, estimating, project controls, change management, claims, and risk ~ Experience with both self-performed and...ClaimsContract workTemporary workFor contractorsFor subcontractorRelocation package- ...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
- ...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
$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- ...expert in order to maintain and advance its health insurance claims processing system, ACAPS.Job DescriptionThe EDI Expert is responsible... ...health providers at IDOH, are loaded into our database, are adjudicated based on state and national pricing standards, and as...Claims
- ...expert in order to maintain and advance its health insurance claims processing system, ACAPS.Job DescriptionThe EDI Expert is responsible... ...health providers at IDOH, are loaded into our database, are adjudicated based on state and national pricing standards, and as...Claims
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- ...role, you will accurately process customer bills and insurance claims, assist with daily and month-end billing activities, answer... ...work ethic, and willingness to learn Experience with claims adjudication and an understanding of how insurance works Healthcare experience...ClaimsFull timeTemporary workWork at officeRemote workFlexible hours
- ...stakeholders to collect outstanding balances and resolve rejected claims. You will also assist with billing inquiries, payment... ...related experience An understanding of insurance and claims adjudication is preferred Healthcare experience is helpful, but pharmacy...ClaimsFull timeTemporary workWork at officeRemote workMonday to FridayFlexible hours
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- ...regulatory reporting, HR data analytics, and annual training requirements; respond to EEOC, ADA, workers’ compensation, and unemployment claims; and partner with the Firm’s General Counsel and Labor Counsel on employment matters as needed. Other duties as assigned....ClaimsFull timeWork at officeLocal area
- ...-15 staff. This role involves managing patient interactions primarily via phone and email, coordinating insurance verification and claims processes under supervision, and providing excellent customer service. The position offers opportunities for growth and promotion within...ClaimsWork at office
$95k
...career in a fast-paced, collaborative environment. This role will focus primarily on litigation involving automobile-related tort claims, with opportunities to expand into complex product liability and warranty matters over time. The ideal candidate is self-motivated,...ClaimsShift work2 days per week- ...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...
- ...Sales Development Representative Balance Platforms, LLC is a leading Business Process Outsourcing firm, specializing in claims administration and job file management for contractors. We partner with industry-leading technology platforms and service vendors to ensure...ClaimsFor contractors
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$45k - $65k
...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:...ClaimsFor contractors
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