Major Loss Claims Adjuster
Keeper- Full Time
- Senior (5 to 8 years)
Candidates must possess a Bachelor’s degree, along with a minimum of 2 years of management and medical insurance claims experience, or 4 additional years of relevant work experience may be substituted in lieu of a degree. They should have current knowledge of technologies in the health information sector, working knowledge of CPT, ADA, HCPCs, ICD-10 codes, UB-04 claim forms, 1500s, HIPAA, medical terminology, X12 837 transactions, insurance regulations, and insurance benefits, and strong interpersonal skills.
The Claims Manager will be accountable for providing leadership to the Claims team by organizing, managing, and directing personnel and workflow to achieve timely and accurate disposition of claims, while maintaining production standards and quality results. They will also plan, schedule, and direct the activities of the claims processors to achieve service performance and retention targets, position the team for successful management of new and existing products, provide effective oversight of third-party administrators and other business partners, participate in due diligence process as needed, manage processes to achieve maximum efficiency while maintaining service standards, support business initiatives through resource sharing and collaboration, and resolve escalated issues arising from operations and requiring coordination with other teams.