Claims Processing Director jobs in Hillsboro, OR

Claims Processing Director plans 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. Being a Claims Processing Director develops and executes strategic business plans for the department. Coordinates operations with other areas of the organization. Additionally, Claims Processing Director requires a bachelor's degree. Typically reports to top management. The Claims Processing Director 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 functional infrastructure. To be a Claims Processing Director typically requires 5+ years of managerial experience. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. (Copyright 2024 Salary.com)

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Claims Adjuster I
  • Capital Claims Management, LLC.
  • Newberg, OR FULL_TIME
  • Claims Adjuster I – JOB AD

    Job Type: Full-time, In-Office

    Pay: $60,000 - $70,000

    Who Are We?

    Capital Claims Management ("CCM") is a boutique insurance claims adjusting firm providing claims handling, defense, and program management services to insurance carriers.

    At CCM, we promote work-life balance and provide an enjoyable, low-stress work environment. A welcoming environment committed to developing and accentuating each person’s specific talents. We are different from large carriers who are very metric-driven, with vastly high demands and management that is far removed from direct claims handling. We provide extensive support to our staff’s ongoing success, requiring nearly half the intake and claim volume larger carriers put on their employees. Plus, we offer competitive pay scales. If you are at the end of your rope with your current employer, you may find much more job satisfaction at CCM.

    What Is The Opportunity?

    In this role, you will primarily handle third-party claims involving Professional Liability (E&O) and Commercial General Liability insurance. Your claim load will consist of non-litigated PL and CGL claims.

    As a Claims Adjuster I, you will handle a reasonable load of claims. You will investigate and determine coverage and liability. You will engage with all relevant parties; and accurately, efficiently work to resolve claims. A management team, claims assistants team, and peers will be available for support, to offer guidance, or approval for a higher level of authority.

    What Will You Do?

    1. Interview and correspond with insureds, claimants, and other parties to complete coverage & liability investigations and resolve claims.

    2. Make determinations on coverage and liability based on submitted evidence, discussions, contractual agreement provisions, and applicable local statutes.

    3. Write position letters consisting of: Declinations of Coverage, Reservations of Rights, Denials of Liability, and Offers.

    4. Approve payment of claims within a specific monetary limit.

    5. Guide negotiations, attempting settlement prior to legal actions for claimed losses.

    6. Comply to standards set by carrier’s Best Practices and CCM procedures.

    What Does Our Ideal Candidate Look Like?

    1. 3 years claims adjusting experience. Ideally in property, professional liability, or commercial liability. Workers’ compensation experience will be considered, but is not preferred.

    2. Experience working in insurance.

    3. Litigation experience either via prior experience claims handling, or at a law firm.

    4. Excellent customer service and conflict resolution skills.

    5. Excellent written and verbal communication skills.

    6. Prior experience authoring formal coverage and liability determination letters.

    7. Deadline and detail-oriented with time management skills and executive functioning skills. Professionalism is closely observed.

    8. Investigation skills, initiative, self-driven.

    9. Acquired a Bachelor's degree.

    10. Experience with claims-made policies preferred.

    11. General knowledge of residential construction or home inspections is a huge plus.

    We offer Medical, PTO, 401(k) matching, Life Insurance, Vision, Dental, and a variety of other generous benefits.

    CCM is an Equal Opportunity Employer

    Job Type: Full-time

    Pay: $60,000.00 - $70,000.00 per year

    Benefits:

    • 401(k)
    • 401(k) matching
    • Dental insurance
    • Employee assistance program
    • Flexible schedule
    • Flexible spending account
    • Health insurance
    • Health savings account
    • Life insurance
    • Paid time off
    • Referral program
    • Tuition reimbursement
    • Vision insurance

    Schedule:

    • 8 hour shift
    • Day shift
    • Monday to Friday
    • No nights
    • No weekends

    Work setting:

    • In-person
    • Office

    Education:

    • Bachelor's (Preferred)

    Experience:

    • Claims Adjusting: 3 years (Preferred)
    • Litigation: 1 year (Preferred)

    Work Location: In person

  • Just Posted

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HR Director - Processing
  • Pacific Seafood
  • Clackamas, OR FULL_TIME
  • At Pacific Seafood, we do more than just provide the world with the healthiest proteins on the planet. We are an excellence-driven organization committed to being the brand of choice in the marketplac...
  • 15 Days Ago

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Field Technician
  • Hancock Claims Consultants
  • Beaverton, OR CONTRACTOR
  • CLIMB to New Heights… And live the_ American Dream. _Become part of something bigger by contracting with the nation’s top provider of roof and property inspection services working with insurance carri...
  • 3 Days Ago

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Field Technician
  • Hancock Claims Consultants
  • Vancouver, WA CONTRACTOR
  • CLIMB to New Heights… And live the_ American Dream. _Become part of something bigger by contracting with the nation’s top provider of roof and property inspection services working with insurance carri...
  • 3 Days Ago

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Workers Compensation Adjuster
  • TheBest Claims Solutions
  • Portland, OR FULL_TIME
  • To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudic...
  • 7 Days Ago

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Sterile processing
  • SCA Health
  • Portland, OR FULL_TIME
  • Overview : East Pavilion Surgery Center is a state-of-the-art ambulatory surgery center (ASC) jointly owned and managed by SCA Health. We have 5 operating rooms and offer patients services in General ...
  • Just Posted

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0 Claims Processing Director jobs found in Hillsboro, OR area

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Medical Policy Implementation Analyst Sr
  • Cambia Health Solutions, Inc
  • Portland, OR
  • Medical Policy Implementation Analyst Sr Remote in ID, OR, WA, UT Primary Job Purpose The Medical Policy Implementation ...
  • 3/28/2024 12:00:00 AM

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Credentialing Specialist
  • Virginia Garcia Memorial Health Center
  • Hillsboro, OR
  • At Virginia Garcia Memorial Health Center, we welcome diversity; we encourage, uplift, and are honored to serve people w...
  • 3/28/2024 12:00:00 AM

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Selling Branch Manager
  • Adecco.
  • Portland, OR
  • Job DescriptionAbout the role The Branch Manager is responsible for building and executing business plans designed to br...
  • 3/28/2024 12:00:00 AM

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Senior Leave Management Specialist (Remote/Full-Time) Human Resources Portland, OR
  • Careerbuilder
  • Portland, OR
  • Trupp HR - Senior Leave Management Specialist (Remote/Full-Time) Pay Range: $70,000 to $75,000 annually Status: Exempt A...
  • 3/28/2024 12:00:00 AM

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Clinical Documentation Specialist (Academic Medical Center Exp) - 100% Remote
  • Amerit Consulting
  • Portland, OR
  • Overview: Our client, a Medical Center facility under the aegis of a California Public Ivy university and one of largest...
  • 3/26/2024 12:00:00 AM

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Bilingual Payroll Manager
  • Teufel Landscape
  • Cornelius, OR
  • Job Description Job Description Teufel Holly Farms remains a local, family-owned business passionately committed to cont...
  • 3/25/2024 12:00:00 AM

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Safety Coordinator
  • Energize My Career
  • Tualatin, OR
  • Responsible for understanding, upholding, and promoting four Critical Success Factors: Safety First! Financial Success. ...
  • 3/25/2024 12:00:00 AM

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Healthcare Facilities Manager / Asset Manager III
  • Bernhard
  • Portland, OR
  • Bernhard’s core mission is delivering innovative engineering, construction, and energy solutions that empower our client...
  • 3/24/2024 12:00:00 AM

Hillsboro (/ˈhɪlzbəroʊ/) is the fifth-largest city in the State of Oregon and is the county seat of Washington County. Lying in the Tualatin Valley on the west side of the Portland metropolitan area, the city hosts many high-technology companies, such as Intel, that comprise what has become known as the Silicon Forest. At the 2010 Census, the city's population was 91,611. For thousands of years before the arrival of European-American settlers, the Atfalati tribe of the Kalapuya lived in the Tualatin Valley near the later site of Hillsboro. The climate, moderated by the Pacific Ocean, helped ma...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Processing Director jobs
$164,305 to $220,789
Hillsboro, Oregon area prices
were up 3.9% from a year ago

Claims Processing Director in Portsmouth, NH
Insurance claims and processing clerks work closely with insurance brokers and agents, handling the administrative duties behind insurance policy renewals, claims processing and new policies.
December 28, 2019
Claims Processing Director in Santa Barbara, CA
Complete with new dashboards, reporting functionality, business intelligence tools, and improved security, FileHandler Enterprise is the new benchmark for Claims Management Software.
February 08, 2020
Claims Processing Director in San Diego, CA
Pulpstream makes it possible for you to have one system for tracking all claims.
January 07, 2020