Director Claims Administration
Core
Lead and develop a high-performing claims adjudication team to ensure accurate, timely, and efficient payment of claims across all product lines.
Role type
Director, Claims Administration
Builds
Claims payment processes and service-levels for health care plans
Domain
Health insurance / Claims administration
Deliverable
client delivery
Required skills
Team leadership, staffing management, service-level monitoring, medical trend management, cost control, process improvement, roadmap development, regulatory compliance
Preferred skills
Health care plan claims experience, prior claims administration management experience
Responsibilities
Lead and develop a high performing claims adjudication team, Implement goals setting and monitoring for service-levels and cost savings, Ensure compliance with state and federal rules and regulations, Initiate process improvement and cost-saving measures, Develop multi-year roadmaps for unit costs and service levels, Coordinate with other departments to support overall customer service
