Claims Processing Director jobs in Pensacola, 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)

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Workers' Compensation Claims Director
  • LandrumHR
  • Pensacola, FL OTHER
  • Workers' Compensation Claims Director
    LandrumHR in Pensacola is looking to bring in a hardworking and reliable Workers' Compensation Claims Director who oversees the various facets of workers’ compensation claims and medical case management as indicated in the performance of the following job duties. This is an excellent opportunity for someone who is looking for steady, full-time work with a company that looks after its employees.

    What you’ll be doing:
    • Manage and lead team, providing guidance, mentorship, and support to ensure delivery of objectives.
    • Conduct periodic performance evaluations and provide constructive feedback to team members, setting goals and expectations and ensuring alignment with overall organizational objectives.
    • Responsible for PEO & WFS clients/employees reporting new injuries and directing medical care if appropriate.
    • Determines compensability of claims and coordinates medical appointments/referrals for injured employees.
    • Manages Medical and Indemnity WC claims - by maintaining rapport through phone contact, meetings, and correspondence with injured employees, physicians, adjusters, rehabilitation providers, physical and occupational therapists, and employers when needed.
    • Assists employee/employer/physician with stay or return to work efforts including work-related restrictions.
    • Prepares online First Report of Injury for respective insurance company within 2 days from report to LandrumHR.
    • Completes Wage Loss Statements.
    • Updates / maintains accurate claim information in LandrumHR CRM database, which includes correspondence, medical treatment notes, future appointments and return to work status.
    • Ensures claimants are following up with requisite medical treatment/appointments.
    • Collaborates with TPA and Carrier adjusters to facilitate the best claim outcomes.
    • Manages complex litigated claims, attends mediations, and possibly final hearings, and depositions and testifies at hearings if necessary.
    • Conducts strategic settlement planning with assigned claims adjuster and defense attorneys.
    • Obtains and Reviews Injury / Incident & Investigation Report.
    • Responsible for reviewing monthly loss run reports (PMA & Liberty Mutual) for accuracy to ensure claim closure promptly.
    • Provides updates on select open claims at monthly meetings.
    • Review Post Job Offer Medical questionnaires to identify concerns about noted limitations and job description.
    • Communicates with CFO on all settlement offers and significant incurred claim changes.
    • Collaborates with the Director of Risk Management to target client strategies based on trends, claim investigations, and onsite safety inspections/training.
    What you’ll bring to the job:
    • Minimum of an associate degree and 5 years WC claims experience or related insurance / claims management experiences.
    • If no college degree must have a minimum of 7 years of experience in WC Claims management, and knowledge of, Florida’s Workers’ Compensation Law.
    • Knowledge of OSHA regulations particularly record keeping is preferable.
    • State Workers’ Compensation Adjuster license is required.
    • Must maintain required Workers’ Compensation Adjuster CEU’s.
    • Certifications such as Associate in Claims (AIC) or Certified Workers’ Compensation Professional are preferred.
    • Ability to manage and develop a high-performing team.
    • Availability to work beyond regular business hours when necessary.
    • Availability for potential travel commitments.
    What’s in it for you:
    • Potential to showcase what you can do and potentially earn a permanent position after working 600 hours with LandrumHR
    • After meeting the qualification requirements, employees are offered: Health Insurance, Dental Insurance, Vision Insurance, Matching 401k
    LandrumHR Workforce Solutions does not discriminate based on race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, marital status, pregnancy, genetic information or any other characteristic protected by law. It is our intention that all qualified applicants are given equal opportunity and that employment decisions be based on job-related factors.
  • 24 Days Ago

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SIU Investigator
  • Claims Investigation Agency
  • Pensacola, FL TEMPORARY,CONTRACTOR
  • Surveillance Investigators needed for South Florida. (TriCounty) Claims Investigation Agency, Inc. is a well-known and respected and continuously growing investigative company that has been in busines...
  • 15 Days Ago

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Processing technician
  • Biolife Plasma Services
  • Pensacola, FL FULL_TIME
  • Job Description About BioLife Plasma Services Every day at BioLife, we feel good knowing that what we do helps improve the lives of patients with rare diseases. While you focus on our donors, we’ll su...
  • 7 Days Ago

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Sample Processing Technician
  • Biolife Plasma Services
  • Pensacola, FL FULL_TIME
  • By clicking the “Apply” button, I understand that my employment application process with Takeda will commence and that the information I provide in my application will be processed in line with Takeda...
  • 4 Days Ago

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Material Processing Maintenance Technican
  • easternshipbuilding
  • Panama, FL FULL_TIME
  • Job Title Material Processing Maintenance Technican Location Panama City, FL US (Primary) Job Type Full-time Education High School / GED Travel None Security Clearance Required None Job Description Pu...
  • 21 Days Ago

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Loan Protection Claims Processor
  • LandrumHR
  • Pensacola, FL OTHER
  • Loan Protection Claims Processor A well-known company in Pensacola is searching for a Loan Protection Claims Processor to evaluate, approve/disapprove, and process Loan Protection Claims and resolve c...
  • 11 Days Ago

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0 Claims Processing Director jobs found in Pensacola, FL area

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Physician-Reassignment OCA-Internal Employees Only
  • Department Of Veterans Affairs
  • Pensacola, FL
  • Summary This is an OPEN CONTINUOUS ANNOUNCEMENT in support of Central Arkansas Veterans Health Care System (CAVHS) Physi...
  • 4/19/2024 12:00:00 AM

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P&C Insurance Agent
  • Legacy Insurance Brokers LLC
  • Pensacola, FL
  • Job Description Job Description We are seeking dynamic insurance professionals who are hard working, detail oriented and...
  • 4/19/2024 12:00:00 AM

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Box Office & Ticket Sales Intern
  • The Studer Family of Companies
  • Pensacola, FL
  • Job Type Internship Description An intern with the Pensacola Blue Wahoos will learn in an organization and environment t...
  • 4/19/2024 12:00:00 AM

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Independent Insurance Claims Adjuster in Gulf Breeze, Florida
  • MileHigh Adjusters Houston Inc
  • Gulf Breeze, FL
  • Exciting Opportunity for Aspiring Claims Adjusters! INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW! Are you ready to ...
  • 4/17/2024 12:00:00 AM

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Life Insurance Sales Agent Remote
  • Lagniappe Agency (Symmetry Financial Group)
  • Gulf Shores, AL
  • Organization Description: No Cold Calling. Unique Sales and Ownership Opportunity. Commission Only Position Are you some...
  • 4/17/2024 12:00:00 AM

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Claims Adjuster Trainee
  • Progressive Corp.
  • Pensacola, FL
  • Claims Adjuster Trainee **Job Number** : 186399 Join one of FORTUNEs 100 Best Companies to Work For! As a **claims adjus...
  • 4/16/2024 12:00:00 AM

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Clerical
  • Encore Rehabilitation
  • Lillian, AL
  • Front Office/Receptionist Job Description/Summary PRIMARY FUNCTION The Receptionist is a non-licensed worker who has com...
  • 4/15/2024 12:00:00 AM

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Work From Home Sales Agent
  • The Jernigan Agency
  • Pensacola, FL
  • This Jernigan Agency is looking for individuals interested in working remotely as sales representatives. We are hiring c...
  • 4/15/2024 12:00:00 AM

Pensacola (/ˌpɛnsəˈkoʊlə/) is the westernmost city in the Florida Panhandle, approximately 13 miles (21 km) from the border with Alabama, and the county seat of Escambia County, in the U.S. state of Florida. As of the 2010 census, the city had a total population of 51,923, down from 56,255 at the 2000 census. Pensacola is the principal city of the Pensacola metropolitan area, which had an estimated 461,227 residents in 2012. Pensacola is a sea port on Pensacola Bay, which is protected by the barrier island of Santa Rosa and connects to the Gulf of Mexico. A large United States Naval Air Statio...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Processing Director jobs
$143,701 to $193,106
Pensacola, 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