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
- ...Kokosing is the winning team.Job Description:Position Summary: The Vice President of Risk is responsible for leading the enterprise-wide risk... ...direction of all risk-related functions, including insurance, claims, contract risk and compliance, and loss prevention.The Vice...ClaimsFull timeContract workFor contractorsFor subcontractorWork at office
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- ...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
$48k - $55k
Tata Consultancy Services is seeking a Claims Manager to handle Absence case management and adjudication of claims. You will analyze claims, review medical information, and determine benefits due according to US regulations. The ideal candidate will have over 1 year of...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
$183.35k - $242k
...setting, or equivalent. Demonstrated knowledge of state and federal employment discrimination statutes and common law employment claims. Experience handling a full range of labor and employment issues, including policy development, employment agreements, FLSA, FMLA,...ClaimsBank staff- ...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
$259.78k - $397.28k
...Senior Vice President, Facilities OperationsThe Senior Vice President, Facilities Operations will be responsible for leading multiple facilities... ...government, or against any individuals who assist or participate in the investigation of any complaint or discrimination claim....ClaimsTemporary workWork experience placementLocal areaFlexible hours- ...manner: Greet patients, visitors and others upon entry Process prescriptions by performing data entry, adjudication of insurance claims, filling and providing medications to patients at pick-up Support the clinical staff with obtaining information for...ClaimsFull timeTraineeshipWork at officeMonday to Friday
- ...A leading training provider for insurance claims adjusters is seeking Licensed Claims Adjusters to join their thriving team in Westerville, Ohio. This role offers the flexibility to assist in disaster recovery while making a significant impact on people's lives. Whether...ClaimsFlexible hours
- ...A leading claims adjustment service in Columbus, Ohio, is seeking independent insurance claims adjusters. This rewarding career allows you to help individuals and businesses recover from disasters, providing flexibility and competitive compensation. Comprehensive training...ClaimsFlexible 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 leading training provider for insurance claims adjusters is seeking Licensed Claims Adjusters to join their thriving team in Westerville, Ohio. This role offers the flexibility to assist in disaster recovery while making a significant impact on people's lives. Whether...ClaimsFlexible hours
- Nationwide’s Property and Casualty team seeks a Claims Specialist to analyze, manage and resolve insurance coverage and claims with low to moderate complexity and exposure. You will investigate, evaluate and negotiate claims to settlement, supporting management liability...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
$5,000 per month
...matches dollar for dollar up to 2% of base pay. Moving Expense: $10,000 paid to moving company Malpractice Insurance Coverage: in a claims made insurance, in an amount of $2,000,000, per claim/$6,000,000, aggregate Health Insurance: physician pays small premium,...ClaimsContract work- The Ohio State University seeks an Optometry Claims Coordinator 2 for the Optometry Clinic. You will manage insurance claims, accounts receivable, and patient billing while ensuring accurate data entry and timely processing. Responsibilities include claim submission, prior...Claims
- CNA Insurance seeks an experienced claims professional to manage complex commercial claims with large exposures, following strict procedures to verify coverage, investigate, and disburse within authority. You will collaborate with partners, counsel, and experts to resolve...Claims
- A leading claims adjustment firm is seeking Independent Insurance Claims Adjusters to join their team in Lewis Center, Ohio. This dynamic role allows you to help clients recover from disasters while enjoying flexibility and competitive compensation. The firm offers comprehensive...ClaimsFlexible hours
- A leading claims adjustment service in Columbus, Ohio, is seeking independent insurance claims adjusters. This rewarding career allows you to help individuals and businesses recover from disasters, providing flexibility and competitive compensation. Comprehensive training...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
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