Department: Claims
Schedule/Hours: As required
Job Summary:
Directs the activities of claims administration staff in providing the timely and accurate processing of claims, encounters, and OPL recoveries. Directs the activities related to billing and reconciliation of premium payment by employers and individuals. Directs the activities of contract administration function in appropriate and timely software updates, code/fee configurations, and overall provider and contract administration. Directs the activities of payment integrity staff in root cause analysis of claims related issues, third party vendor oversight, and claims related risk adjustment processes. Supports the implementation of software enhancements.
Minimum Qualifications:
Bachelor's degree (BA/BS) from four-year college or university; or one to two years' related experience and/or training; or equivalent combination of education and experience. Ten years related experience preferred.
Claims Operations Director • Tallahassee, FL, USA
Santander is a global leader and innovator in the financial services industry and is evolving from a high-impact brand into a technology-driven organization.Our people are at the heart of this jour...[internal_linking.show_more]
The home improvement industry is broken.Were on a mission to revolutionize home improvement, making it faster, easier, and stress-free to upgrade your home inside and out.Whether its a new bath, a ...[internal_linking.show_more]
A leading insurance provider in Tallahassee is looking for an experienced Catastrophe Claims Representative to manage multi-line property and casualty claims.The role requires investigating claims,...[internal_linking.show_more]
As The Discovery and Conversion Company, our mission is to connect consumers with the world’s leading brands through data-driven content and technology.Headquartered in South Florida with a remote-...[internal_linking.show_more]
A healthcare technology company is seeking a Claims Manager in Tallahassee, FL.The successful candidate will lead billing processes, manage a team, and ensure compliance with healthcare policies.Re...[internal_linking.show_more]
A national claims services provider is seeking a Claims Representative to manage low-level general liability claims.This remote position requires an active adjuster license and a background in clai...[internal_linking.show_more]
A dynamic organization supplying quality claims outsource solutions to insurance carriers, countrywide is seeking multi-line adjusters in your area.There are many competing vendors in our marketpla...[internal_linking.show_more]
Job Title: Managing Director - IT Managed Services.Cayuse Company: Cayuse Commercial Operations.Department: Business Development/IT.The Managing Director of IT Managed Services is a dynamic, entrep...[internal_linking.show_more]
A technology solutions provider is seeking a Managing Director for IT Managed Services to drive growth and operational excellence.In this hybrid role, you will lead the sales, development, and deli...[internal_linking.show_more]
The Director of Grounds Operations serves as a visionary steward of Florida State University's physical environment, leading with purpose to cultivate a campus landscape that reflects the excellenc...[internal_linking.show_more]
We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies.Working here means having every opportunity to achieve your goals - and t...[internal_linking.show_more]
Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise.Our mission is to innovate health solutions that deliver maximum value and impact.Lead t...[internal_linking.show_more]
This job is responsible for directing negotiation of the plan's key contracts with health care providers (hospitals, PHOs, physicians, intermediate care providers).Directs financial analyses of the...[internal_linking.show_more]
Essential Duties and Responsibilities:.Lead the design and development of complex software applications from business requirements in collaboration with other team members.Investigate new solutions...[internal_linking.show_more]
Testing Operations Manager - Office of Digital Learning & Academic Technology.Office of Digital Learning & Academic Technology.Serves as the primary supervisor of the testing team.Delegates respons...[internal_linking.show_more]
A leading healthcare organization is seeking a Director of Authorizations & Eligibility to oversee authorization and insurance eligibility processes in a complex Home Health environment.The ideal c...[internal_linking.show_more]
The Operations Manager is a member of the Store Management team, and as such, fulfills the company purpose of helping people on their path to better health by driving store execution and performanc...[internal_linking.show_more]
This position will be Remote, but with a preference for candidates in Pennsylvania, Virginia, North Carolina, Texas, Louisiana, and Mississippi***.This is your chance to be part of an in-house Bran...[internal_linking.show_more]
