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View salary and benefits informationPlans and directs one or more departments responsible for administration of health insurance claims, payment processing, billing research, and responding to inquiries. Establishes and implements organizational policies and procedures; may offer guidance on the appropriate handling of complex or high-value claims. Develops and executes strategic business plans for the department. Coordinates operations with other areas of the organization. Requires a bachelor's degree. Typically reports to top management. Manages a departmental sub-function within a broader departmental function. Creates functi more...
Directs and oversees the operations of an insurance claims department to meet operational, financial, and service requirements. Establishes policies and procedures for the administration of insurance claims for personal, property, or casualty loss based on coverage, appraisal, and verifiable damage. Responsible for the strategic processing and payment of claims. Maintains up-to-date- knowledge of legislation, regulations, and industry events which pertain to insurance claims. Provides expert guidance and consultation to staff on the most complex claims. Requires a bachelor's degree. Typically more...
Directs and oversees the operations of the claims quality audit department to follow the audit policies, procedures and regulation. Provides professional knowledge and guidance on technical or procedural problems. Creates claims audit policies and procedures. May recommend changes in claims processing procedures. Typically Requires a bachelor's degree. Typically reports to top management. Manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the f more...
Manages the administration of health insurance claims, payment processing, billing research, and responding to inquiries. Ensures timely and proper disposition of claims in accordance with coverage amounts. Trains staff on organizational policies and ensures procedures are followed at all times. Provides guidance on more complex or high-value claims. Typically requires a bachelor's degree. Typically reports to a head of a unit/department. Manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and more...
Supervises the administration of health insurance claims, payment processing, billing research, and responding to inquiries. Ensures the accurate and timely disposition of claims and resolves matters according to coverage amounts and company procedures. Provides guidance to staff on more complex or high-value claims. Reviews and resolves escalated issues. Requires a high school diploma. Typically reports to a manager. Supervises a small group of para-professional staff in an organization characterized by highly transactional or repetitive processes. Contributes to the development of processes more...
Receives and inputs new healthcare claims, processes payments, conducts billing research, and responds to telephone inquires. Evaluates claims and administers payment, denies, or returns claims according to policy provisions and organizational guidelines. Produces routine and ad hoc reports. Requires a high school diploma. Typically reports to a supervisor. Works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. Typically requires 1-3 years of related experience. more...
Receives and inputs new healthcare claims, processes payments, researches billing issues, and responds to email and telephone inquiries. Evaluates claims and administers payment, denies, or returns claims according to policy provisions and organizational guidelines. Produces routine and ad hoc reports. Requires a high school diploma. Typically reports to a supervisor. Works under the close direction of senior personnel in the functional area. Possesses a moderate understanding of general aspects of the job. May require 0-1 year of general work experience. more...
The Medical Claims Operations Director establishes and implements organizational policies and procedures; may offer guidance on the appropriate handling of complex or high-value claims. Plans and directs one or more departments responsible for administration of health insurance claims, payment processing, billing research, and responding to inquiries. Being a Medical Claims Operations Director coordinates operations with other areas of the organization. Develops and executes strategic business plans for the department. In addition, Medical Claims Operations Director requires a bachelor's degre more...
The Claims Service and Operations Director provides guidance and sets policies on insurance claims for personal, property, or casualty loss based on coverage, appraisal, and verifiable damage. Directs and oversees the operations of an insurance claims department to meet operation, financial, and service requirements. Being a Claims Service and Operations Director keeps abreast of any changes to legislation and regulations which pertain to insurance claims. Responsible for the strategic processing and payment of claims. In addition, Claims Service and Operations Director provides guidance to su more...
Receives and inputs new healthcare claims, processes payments, conducts billing research, and responds to telephone inquires. Evaluates claims and administers payment, denies, or returns claims according to policy provisions and organizational guidelines. Produces routine and ad hoc reports. Requires a high school diploma. Typically reports to a supervisor. Works independently within established procedures associated with the specific job function. Has gained proficiency in multiple competencies relevant to the job. Typically requires 3-5 years of related experience. more...
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