Claims Manager manages the operations of an insurance claims department to meet operational, financial, and service requirements. Oversees the intake and processing of insurance claims for personal, property, or casualty loss based on coverage, appraisal, and verifiable damage. Being a Claims Manager manages appraisal and examination staff and processes. Assures timely and proper disposition of claims based on policy provisions. Additionally, Claims Manager recommends and implements best practices to ensure complete and thorough claim settlements, legal reviews, and investigations following company policies and insurance industry regulations. Determines the value of settlements for escalated claims. Manages negotiations of settlements and administration of claims in litigation. Typically requires a bachelor's degree. Typically reports to a director. The Claims Manager 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 adhering to approved budgets. Has full authority for personnel actions. To be a Claims Manager typically requires 5 years experience in the related area as an individual contributor. 1-3 years supervisory experience may be required. Extensive knowledge of the function and department processes. (Copyright 2024 Salary.com)
ABOUT THE ROLE:
The Manager of Claims Operations/Payment Integrity will play a key role in achieving the highest-level of claims excellence through creation and implementation of consistent business processes aligning with strategic goals of the XO Health Operations Department. The Manager of Claims Operations/Payment Integrity will work closely with the SVP of Operations and Payment Integrity and other departments to develop, communicate, implement, execute, and measure claim business processes.
RESPONSIBILITIES:
EXPERIENCE REQUIRED:
The qualified candidate will have:
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