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- ...Job Description Job Description Title: Regional Vice President, Sales Location: Baltimore, Maryland or Rockville, Maryland (Montgomery... ...business development. Full training on the product and the claims process is provided. What You'll Do Solicit new...ClaimsBase plus commissionFull timeLocal area
- ...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
$360k - $400k
...are appropriately developed and communicated.Ensure compliance with federal, state and local regulations: Directs unemployment claims, workers compensation claims, ADA, OSHA logs and reporting.Oversee employee and labor relations and investigations: Manages senior...ClaimsFull timeTemporary workWork at officeLocal area- ...worker classification, whistleblowing, data privacy, reductions in force, workplace injury, credit and criminal checks, and waivers of claims ~ Litigation experience strongly preferred, particularly FINRA arbitrations related to U-5 filings ~ Experience advising...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 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 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
$128k - $177k
...Job Title: Vice President of Human Resources and Legal Department: Headquarters Location: Hybrid, Washington, D.C. Reports to... ...primary internal point of contact. Manage legal disputes, claims, and threatened litigation in partnership with outside counsel...ClaimsFull timeContract workWork at officeLocal areaImmediate startRemote workRelocationFlexible hoursNight shiftWeekend workAfternoon shift- ...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
- ...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 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
$190k - $220k
...partners. For each other. Requirements: The Role The Vice President, National Sales leads Brook’s sales organization and owns new-... ...prorated by hire date). Medical concierge — concierge support for claims, referrals, and care coordination, for employees and their...ClaimsFull timeTemporary workRemote workFlexible hours- ...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
$208.28k
...OVERVIEW Job Description Summary:Reporting to the Executive Vice President and Chief Financial Officer (EVP/CFO), the Vice President, Treasurer... ...university leadership and legal counsel on risk mitigation, claims management, and business continuity planning.Lead the future...ClaimsContract workTemporary workPart timeCasual workWork at officeRemote workVisa sponsorshipWork visaMonday to FridayAfternoon shift- ...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
- ... Position Title Senior Vice President/Chief Legal Officer Job Description Summary Join VHC Health... ...laws and regulations such as HIPAA, Stark Law, and the False Claims Act, while also overseeing real estate and commercial...ClaimsHourly payFull timeContract workFor contractorsShift work
$196.95k - $325k
...results, and shape the future of Mission Technologies.SummaryThe Vice President, Contracts, Pricing & Procurement for HII Mission Technologies... ...from award through closeout, including modifications, claims, REAs, options, and terminations.Ensure compliance with FAR, DFARS...ClaimsFull timeContract workFor contractorsWork experience placementLocal areaWorldwide- Prudential Ins Co of America seeks a Claims Examiner to join the Group Life Claim Team of Beneficiary Fulfillment on the Specialized Client Concierge Team. The role focuses on adjudicating life insurance claims with accuracy, empathy, and timely decisions. You will investigate...ClaimsRemote job
- nTech Workforce is seeking a Claims Resolution Representative for a remote US-based role in McLean, VA. The position focuses on direct payer-side claims adjudication, reviewing provider-submitted claims, applying policy rules, and determining outcomes. This is a six-month...ClaimsRemote jobContract work
$50k - $55k
...learning, and career development. Summary As a Healthcare Claims Operations Team Lead at Gainwell, you will lead a team... ...oversee end-to-end healthcare claims operations, including claims adjudication, complex issue resolution, payment accuracy, and compliance...ClaimsFull timeFlexible hours- ...Description Job Description Role overview Rubix is seeking a Vice President, Legal to lead legal support for our global AI and digital... ...full project lifecycle: procurement, delivery, commissioning, claims, delay, defects, liens, and site safety ~ Manage...ClaimsWork experience placementPrivate practice
$210k - $260k
...Job Description Job Description VICE PRESIDENT OF HUMAN RESOURCES AND ADMINISTRATIONAbout the Foundation for Defense of DemocraciesFDD... ..., including exit interviews, COBRA notices, unemployment claims, and systems deprovisioning.Employee Relations & CultureServe...ClaimsFull timeFor contractorsWork at officeLocal areaRemote work2 days per week- ...Appointment subject to background investigation and favorable adjudication. Males born after 12-31-59 must be registered for Selective Service... ...spouses, and minor children may not acquire or retain any claim, permit, lease, small tract entry, or other rights granted by...ClaimsPermanent employmentFull timePart timeWork at officeImmediate start
$200k
...Refine the ICP, size-tiered pricing model, and product positioning Customer Development — Lead pilots with managing partners and claims/litigation-operations leads at small-to-mid insurance-defence firms, starting from the confirmed design partner, convert them to...ClaimsFull timeImmediate start$89k - $95k
...and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards... ...high dollar charges if applicable. Determines whether to pend or adjudicate claims following organizational policies and procedures;...ClaimsShift work- ...insurance to the U.S. mutual fund industry. You’ll work closely with underwriting and senior management on complex insurance coverage, claims, compliance, and corporate matters while developing expertise at the intersection of insurance and investment management. Specific...ClaimsWork experience placement
- ...Collection SpecialistThe collection specialist will focus primarily on resolving insurance claims from Medicare, Medicaid, and commercial plans that are underpaid or denied. They will use their payor knowledge and critical thinking skills to correctly identify denial...Claims
- ...simultaneously while maintaining accuracy, empathy, and professionalism. You will play a critical role in resolving billing issues, processing claim resubmissions, managing patient escalations, and ensuring a positive patient experience. WHAT YOU’LL DO Handle a high volume of...Claims
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