Claims Processing Director jobs in Palm Bay, FL

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)

O
Claims Examiner
  • Orion180 Insurance Services, LLC
  • Melbourne, FL FULL_TIME
  • CITON Claims Solutions, LLC is a premier provider of claim management and administration services for insurance companies, specializing in efficient and innovative solutions tailored to meet each client's unique needs. With a dedicated team of experts and cutting-edge technology, CITON Claims Solutions, LLC ensures seamless processes, accurate assessments, and prompt resolutions, delivering unparalleled value and peace of mind to our clients.

    CITON is located on the beautiful space coast of Melbourne, one of the best places to live in Florida. Melbourne offers affordable housing, transportation, and other amenities. Major cities such as Orlando, Tampa, and Miami are all within one to three hours of driving distance.

    CITON Claims Solutions LLC is a subsidiary of Orion180 Group Inc., and handles Claims Administration, Management, and Investigation.


    Job Summary

    The Claims Examiner - Inside Desk Adjuster has direct responsibility for homeowners' property insurance claims, starting with contacting the insured upon the loss through claims resolution. The Claims Examiner provides world class customer service to insurers, insureds, and agents by empathetically handling each claim and working as efficiently as possible to handle every claim fairly.

    The Claims Examiner is responsible for demonstrating an understanding of insurance principles, claims investigation, damage evaluation, and resolution of property claims, creating a positive customer experience. A Claims Examiner provides prompt, cost effective and efficient examination, investigation, evaluation, and payment of insurance claims by exercising independent decision-making skills and judgment within designated authority. The role of the Claim Examiner is to investigate, evaluate, negotiate, and settle claims in multi-jurisdictions, applying coverage, laws, and regulations; accordingly, reporting to upper management and reinsurers within necessary timelines and guidelines.

    Role and Responsibilities

    To perform the job successfully, the individual must be able to perform each essential duty satisfactorily and should demonstrate the following competencies to consistently perform the essential functions of this position. All employees are expected to adhere to and be knowledgeable of Orion180 operations standards, established security/safety rules and requirements for attendance. The requirements listed below are representative of the fundamental knowledge, skill, and/or ability required to perform the job successfully:


    • Conducts prompt, thorough investigation of claims from initial contact to resolution including research, analysis, and synthesis of all findings.
    • Provides superior customer service to Orion180 policyholders.
    • Determines coverage and identifies coverage issues related to various claims, applying a thorough understanding of applicable insurance policies and relevant coverage and loss types. Issue appropriate Reservation of Rights and/or declination letters.
    • Resolves coverage issues in collaboration with Claims Management.
    • Assesses subrogation potential of losses and recommend files to subrogation examiners as appropriate.
    • Negotiates settlements with insureds and third parties using an object approach to claims resolution.
    • Composes correspondence to insureds, claimants, attorneys, agents, and regulatory agencies.
    • Appropriately and clearly documents all claim file activity, including current strategy, plan of action and exit plan.
    • Effectively presents and discusses loss facts, issues and recommendations in department discussions and meetings.
    • Contact and maintain communication with policyholder, field adjuster and other parties to ensure timely processing of claim.
    • Review adjuster reports and estimates to ensure estimates are technically accurate and meet appropriate industry guidelines for repair.


    Qualifications and Education Requirements

    • 2 years of experience in daily field or desk adjusting is required
    • 2 years of Xactimate/Xactanalysis estimating experience
    • Adjusters license or the ability to obtain required state license
    • Ability to read and interpret insurance policies
    • Ability to write reports, business correspondence, and procedure manuals.
    • Excels at customer service and customer experience
    • Proactive in approach to claim handling
    • Proficient oral and written communications using MS Word, Excel and Outlook
    • Preferred Skills
    • Ability to work with minimal supervision in a team-oriented environment.
    • Must be self-directed and able to meet deadlines.
    • Excellent time management and organizational skills.
    • Ability to work effectively with all levels.
    • Excellent time management and organizational skills.
    • Awareness of business trends.
    • Accuracy and attention to detail.
    • Trustworthiness, integrity, and personal accountability and adherence to standards of ethical behavior and professional conduct

    Physical Demands

    While performing general office duties for this position, the employee is regularly required to sit, stand and/or walk around (including the use of stairs). Other demands include the ability to openly communicate with others by talking, listening, and reading, able to lift light objects (<25lbs), and use standard office equipment such as computer, printer, and phone. In addition, there is an occasional need to bend, twist or stoop to open/close cabinets, reach for files or other standard office type objects.

    Work Environment

    The office environment is generally quiet and, in a temperature, controlled setting with random adjustments in noise or temperature due conversations, unscheduled maintenance repairs to the building or its interior offices or unpredictable situations due to weather or other acts beyond company control. An employee must be willing to work their regularly assigned work schedule for their duties and/or job responsibilities and in times of need, be able to work an extended schedule depending on company/department needs, project requirements or customer demands.


    If you are interested in applying for employment and need special assistance or an accommodation to apply for a posted position, contact our Human Resources department at (321) 460-8484 or HR@orion180.com


    All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status, and will not be discriminated against based on disability.

  • 25 Days Ago

A
Processing Lead, Kuiper Payload Processing Facility
  • Amazon
  • Merritt, FL FULL_TIME
  • DESCRIPTIONProject Kuiper is an initiative to launch a constellation of Low Earth Orbit satellites that will provide low-latency, high-speed broadband connectivity to unserved & underserved communitie...
  • 1 Month Ago

I
CLAIMS & RETURNS COORDINATOR
  • Italian Terrazzo and Ti
  • Melbourne, FL FULL_TIME
  • Italian Terrazzo & Tile Co. of Brevard, LLC Position Title: Installed Claims and Returns CoordinatorDepartment: Supply ChainReports To: Purchasing ManagerPosition Type: Regular full-time General Summa...
  • 17 Days Ago

M
Sterile processing tech
  • Melbourne Regional Medical Center
  • Melbourne, FL FULL_TIME
  • Position Summary : Assembles and wraps surgical instruments and linens for surgical services. Picks supplies and instruments for all scheduled and emergency surgical cases. Operates steam and steriliz...
  • Just Posted

F
Seafood packedging/processing
  • FLORIDA FRESH FISH LOGISTICS LLC
  • Fort Pierce, FL PART_TIME,FULL_TIME
  • Overview: We are seeking a responible, reliable and dedicated person to join our team. The ideal candidate will have experience in the seafood industry and can lift 50 lbs chest high. As a Processor, ...
  • 8 Days Ago

Q
Digital Signal Processing Engineer
  • QUANTUM TECHNOLOGY SCIENCES INC
  • Melbourne, FL OTHER
  • Job Details Level: Experienced Job Location: Quantum Technology Sciences Inc. - Melbourne, FL Position Type: Full Time Education Level: Graduate Degree Salary Range: $130,000.00 - $170,000.00 Salary/y...
  • 24 Days Ago

Filters

Clear All

  • Filter Jobs by companies
  • More

0 Claims Processing Director jobs found in Palm Bay, FL area

G
Insurance Sales Agent
  • GreatFlorida Insurance
  • Melbourne, FL
  • Job Description Job Description We are seeking energetic and driven individuals with a winning spirit to join our fast p...
  • 4/25/2024 12:00:00 AM

S
Life Insurance Sales Representative - Take Control of Your Future Now!
  • Symmetry Financial - Clark Agency
  • Sebastian, FL
  • Are you passionate & perseverant? Do you desire more in life and want to get PAID the true value for how hard you work? ...
  • 4/25/2024 12:00:00 AM

R
Loss Control Consultant - Orlando
  • Regional Reporting Inc
  • Orlando, FL
  • Regional Reporting, Inc. (RRI) is one of the largest independently owned providers of loss control to the property and c...
  • 4/25/2024 12:00:00 AM

J
Assistant Community Manager
  • Jefferson Apartment Group
  • Orlando, FL
  • Description Jefferson Apartment Group is a full-service real estate firm specializing in multifamily and mixed-use real ...
  • 4/24/2024 12:00:00 AM

S
Insurance Sales Representatives Remote
  • Stephens Agency Group
  • Melbourne, FL
  • Job Description Job Description Insurance Sales Representatives Remote Organization Description: We are looking for?Remo...
  • 4/24/2024 12:00:00 AM

W
Risk Adjustment Coding Educator
  • Wellvana
  • Orlando, FL
  • The healthcare system isn't designed for health. We're designed to change that. We're Wellvana, and we help doctors deli...
  • 4/22/2024 12:00:00 AM

R
Insurance Sales Agent / Representative
  • Renegade Insurance
  • Palm Bay, FL
  • Job Description Job Description We're looking for relentless go-getters who thrive on success, strive towards continuous...
  • 4/22/2024 12:00:00 AM

U
Controls Specialist II
  • University of Central Florida
  • Orlando, FL
  • Facilities and Business Operations: The Facilities and Business Operations at UCF is dedicated to fostering a conducive ...
  • 4/21/2024 12:00:00 AM

Palm Bay is a city in Brevard County, Florida. The city's population was 103,190 at the 2010 United States Census, making it the most populous city in the county. It developed at Turkey Creek at its mouth at Indian River, which flows into the Atlantic Ocean. Palm Bay is a principal city of the Palm Bay−Melbourne−Titusville Metropolitan Statistical Area, which had a population of 543,376 at the 2010 census. According to the United States Census Bureau, the city has a total area of 68.8 square miles (178.3 km2), of which 65.7 square miles (170.2 km2) is land and 3.1 square miles (8.1 km2), or 4...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Processing Director jobs
$144,811 to $194,598
Palm Bay, Florida area prices
were up 1.5% 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