Claims Processing Director jobs in Washington

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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EEOICPA Claims Processing and Verification Specialist
  • ProSidian Consulting, LLC
  • Richland, WA FULL_TIME
  • Company Description

    ProSidian is looking for “Great People Who Lead” at all levels in the organization.  Are you a talented professional ready to deliver real value to clients in a fast-paced, challenging environment?  ProSidian Consulting is looking for professionals who share our commitment to integrity, quality, and value.

    ProSidian is a management and operations consulting firm with a reputation for its strong national practice spanning six solution areas including Risk Management, Energy & Sustainability, Compliance, Business Process, IT Effectiveness, and Talent Management.  We help clients improve their operations.   

    Linking strategy to execution, ProSidian assists client leaders in maximizing company return on investment capital through design and execution of operations core to delivering value to customers.  Visit www.ProSidian.com or follow the company on Twitter at www.twitter.com/prosidian for more information.

    Job Description

    ProSidian Seeks a EEOICPA Claims Processing and Verification Specialist located in The Hanford Tri-Cities Area (Kennewick | Pasco | Richland) to support an engagement for the US Dept. of Energy (DOE) Hanford in Eastern Washington (Tri-Cities - Kennewick | Pasco | Richland) Area. 

    The ProSidian Engagement Team Members work to provide General Support Services Contractor (GSSC) assistance to support DOE Hanford [which consists of Richland Operations Office (RL), and Office of River Protection (ORP)] in support of the Govt’s operations, personnel management, and general administration of regional operations at the Hanford Site in Richland, Washington. 

    EEOICPA OP AB Support Candidates shall work to support requirements as a EEOICPA Claims Processing and Verification Specialist and support to the Energy Employees Occupational Illness Compensation Program (EEOICPA) Program Mgr.  across the U.S. Dept.  of Energy (DOE), Richland Operations Office (RL), Assistant Mgr.  for Mission Support (AMMS), Site Stewardship Division (SSD). EEOICPA Claims Processing and Verification Specialist shall provide staff to effectively support the EEOICPA Program Mgr.  in all phases of program implementation, including but not limited to managing all incoming and outgoing EEOICPA claims, preparing verifications of employment, and providing support for data capture requests from the National Institute of Occupational Safety and Health (NIOSH), Dept.  of Labor (DOL) and other involved parties.

    DELIVERABLES

    The EEOICPA Claims Processing and Verification Specialist shall provide support to the DOE-RL EEOICPA Program Mgr. . Such support shall include limited support to the DOE EEOICPA Program Mgr. , as requested, in support of the completion of DOE's requirements to support DOL and NIOSH during on-site data capture visits and in preparation for the data capture visits.  The ProSidian Engagement Team may be required to escort visitors to classified meetings, assist in documenting data captures, and providing other various administrative or basic technical support during these data capture visits, as directed by the EEOICPA Program Mgr.

    Other direct support by definitive work category shall include:

    • Have the ability to review and analyze personnel records for relevant information, as well as skills at preparing summary documents, as requested.
    • After receipt of the information from others on site, ,EEOICPA Claims Processing and Verification Specialist shall compile the entire package including the employment verification prepared, evaluate it for completeness and process the claim to the requesting agents.
    • Ensure that these duties are performed in a competent, professional manner that meets established milestones and delivery schedules.
    • Work products are expected to be thorough, accurate, appropriately documented, and comply with mandated schedules.
    • Contacts with claimants or other EEOICPA related staff are expected to be of the highest competence and professionalism, recognizing the personal dynamics and issues of the claimants and other impacted personnel.

    CLAIMS PROCESSING

    • Provide support on the day-to-day administration, management and tracking of all aspects of the EEOICPA claim process applicable to the Hanford and PNNL facilities and Hanford and PNNL employees.
    • Process all requests in a timely manner, as is within their scope of work and control.
    • Prepare reports, correspondence, copying, computer input, documentation as requested.
    • Communicate effectively with all Federal and contractor staff, as well as with all claimants that are in contact with the office.
    • Keep DOE-RL Program Mgr.  informed of work progress, new issues, concerns, or other items as appropriate.
    • Shipments and electronic downloads/uploads of claim related information shall be in accordance with the DOE-RL EEOICPA Program Mgr. ' s and DOE-HQ direction, policies and procedures
    • Provide routine monthly status reports and other reports as requested by the DOE-RL Program Mgr. . .
    • Conduct research to respond to inquiries from DOL and NIOSH relating to Hanford past practices or history to support claim development. These requests for research will be sporadic but require some specialized knowledge of Hanford's past contractor history.
    • Compile finding aids, as available, that document unusual sources of employment information, including historical lists of Hanford’s contractors.  Manage that information collection in a secure and appropriate manner.

    VERIFICATION OF EMPLOYMENT SUPPORT

    • Provide verification of employment reports on employees for former contractors, based on review and analysis of personnel records available. These verifications should include a narrative of the job title and work location, as well completion of the EE-5 forms required by Dept.  of Labor.

    TECHNICIAN SUPPORT

    • Assist in logging documents/boxes into an established tracking system.
    • Move records boxes from one location in a work area to another to ensure the boxes are accurately staged for various work processes.
    • The ProSidian Engagement Team employee will scan personnel, medical or claim records from paper and electronic format and merge and consolidate the scanned files e-claim files.
    • The .contractor employee will provide typing, scanning, or records management support to EEOICPA claim and other EEOICPA related functions.
    • Create documents, lists or indices from various sources.

    Qualifications

    The EEOICPA Claims Processing and Verification Specialist shall have consecutive employment in a position with comparable responsibilities within the past five (5) years, Must be able to use a computer to communicate via email; and proficient in Microsoft Office Products (Word/Excel/Power point) and related tools and technology required for the position.

    QUALIFICATIONS REQUIREMENTS

    • Depending on specific task assignments, certain permanent employees must have the ability to obtain a “Q” Clearance.
    • High school diploma required;
    • 6 years of relevant experience; and,
    • Contractor must be a U.S. citizen. ​​​​​

    TRAVEL:  Travel, both offsite and local onsite travel on the Hanford Site as coordinated with the EEOICPA Program Mgr.  and Contracting Officer is allowed, in accordance with the Federal Travel Regulations, on an as needed basis. Local travel on the Hanford Site is expected to facilitate the transfer of claim related or data capture related information.

    LOCATION:  Work shall be conducted at the Dept.  of Energy - Richland Operations Office located in Richland, WA.

    Additional Information

    As a condition of employment, all employees are required to fulfill all requirements of the roles for which they are employed; establish, manage, pursue, and fulfill annual goals and objectives with at least three (3) Goals for each of the firms Eight Prosidian Global Competencies [1 - Personal Effectiveness | 2 - Continuous Learning | 3 - Leadership | 4 - Client Service | 5 - Business Management | 6 - Business Development | 7 - Technical Expertise | 8 - Innovation & Knowledge Sharing (Thought Leadership)]; and to support all business development and other efforts on behalf of ProSidian Consulting.  

    CORE COMPETENCIES

    • Teamwork – ability to foster teamwork collaboratively as a participant, and effectively as a team leader
    • Leadership – ability to guide and lead colleagues on projects and initiatives
    • Business Acumen – understanding and insight into how organizations perform, including business processes, data, systems, and people
    • Communication – ability to effectively communicate to stakeholders of all levels orally and in writing
    • Motivation – persistent in pursuit of quality and optimal client and company solutions
    • Agility – ability to quickly understand and transition between different projects, concepts, initiatives, or work streams
    • Judgment – exercises prudence and insight in decision-making process while mindful of other stakeholders and long-term ramifications
    • Organization – ability to manage projects and activity, and prioritize tasks

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    OTHER REQUIREMENTS

    • Business Tools –  understanding and proficiency with business tools and technology, including Microsoft Office. The ideal candidate is advanced with Excel, Access, Outlook, PowerPoint and Word, and proficient with Adobe Acrobat, data analytic tools, and Visio with the ability to quickly learn other tools as necessary.
    • Business Tools – understanding and proficiency with business tools and technology, including Microsoft Office. The ideal candidate is advanced with Excel, Access, Outlook, PowerPoint and Word, and proficient with Adobe Acrobat, data analytic tools, and Visio with the ability to quickly learn other tools as necessary.
    • Commitment - to work with smart, interesting people with diverse backgrounds to solve the biggest challenges across private, public and social sectors
    • Curiosity – the ideal candidate exhibits an inquisitive nature and the ability to question the status quo among a community of people they enjoy and teams that work well together
    • Humility – exhibits grace in success and failure while doing meaningful work where skills have impact and make a difference
    • Willingness - to constantly learn, share, and grow and to view the world as their classroom

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    BENEFITS AND HIGHLIGHTS

    ProSidian Employee Benefits and Highlights: Your good health and well-being are important to ProSidian Consulting. At ProSidian, we invest in our employees to help them stay healthy and achieve work-life balance. That’s why we are also pleased to offer the Employee Benefits Program, designed to promote your health and personal welfare. Our growing list of benefits currently include the following for Full Time Employees:

    • Competitive Compensation: Pay range begins in the competitive ranges with Group Health Benefits, Pre-tax Employee Benefits, and Performance Incentives. For medical and dental benefits, the Company contributes a fixed dollar amount each month towards the plan you elect. Contributions are deducted on a Pre-tax basis.
    • Group Medical Health Insurance Benefits: ProSidian partners with BC/BS, to offer a range of medical plans, including high-deductible health plans or PPOs. ||| Group Dental Health Insurance Benefits: ProSidian dental carriers - Delta, Aetna, Guardian, and MetLife.
    • Group Vision Health Insurance Benefits:ProSidian offers high/low vision plans through 2 carriers: Aetna and VSP.
    • 401(k) Retirement Savings Plan: 401(k) Retirement Savings Plans help you save for your retirement for eligible employees. A range of investment options are available with a personal financial planner to assist you. The Plan is a pre-tax Safe Harbor 401(k) Retirement Savings Plan with a company match.
    • Vacation and Paid Time-Off (PTO) Benefits: Eligible employees use PTO for vacation, a doctor’s appointment, or any number of events in your life. Currently these benefits include Vacation/Sick days – 2 weeks/3 days | Holidays - 10 ProSidian and Government Days are given.
    • Pre-Tax Payment Programs: Pre-Tax Payment Programs currently exist in the form of a Premium Only Plan (POP). These Plans offer a full Flexible Spending Account (FSA) Plan and a tax benefit for eligible employees.
    • Purchasing Discounts & Savings Plans: We want you to achieve financial success. We offer a Purchasing Discounts & Savings Plan through The Corporate Perks Benefit Program. This provides special discounts for eligible employees on products and services you buy on a daily basis.
    • Security Clearance: Due to the nature of our consulting engagements there are Security Clearance requirements for Engagement Teams handling sensitive Engagements in the Federal Marketplace. A Security Clearance is a valued asset in your professional portfolio and adds to your credentials.
    • ProSidian Employee & Contractor Referral Bonus Program: ProSidian Consulting will pay up to 5k for all referrals employed for 90 days for candidates submitted through our Referral Program.
    • Performance Incentives: Due to the nature of our consulting engagements there are performance incentives associated with each new client that each employee works to pursue and support.
    • Flexible Spending Account: FSAs  help you pay for eligible out-of-pocket health care and dependent day care expenses on a pre-tax basis. You determine your projected expenses for the Plan Year and then elect to set aside a portion of each paycheck into your FSA.
    • Supplemental Life/Accidental Death and Dismemberment Insurance: If you want extra protection for yourself and your eligible dependents, you have the option to elect supplemental life insurance. D&D covers death or dismemberment from an accident only.
    • Short- and Long-Term Disability Insurance: Disability insurance plans are designed to provide income protection while you recover from a disability.

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    ADDITIONAL INFORMATION - See Below Instructions On The Best Way To Apply

    ProSidian Consulting is an equal opportunity employer and considers qualified applicants for employment without regard to race, color, creed, religion, national origin, sex, sexual orientation, gender identity and expression, age, disability, or Vietnam era, or other eligible veteran status, or any other protected factor. All your information will be kept confidential according to EEO guidelines.

    ProSidian Consulting has made a pledge to the Hiring Our Heroes Program of the U.S. Chamber of Commerce Foundation and the “I Hire Military” Initiative of The North Carolina Military Business Center (NCMBC) for the State of North Carolina. All applicants are encouraged to apply regardless of Veteran Status.

    Furthermore, we believe in "HONOR ABOVE ALL"  - be successful while doing things the right way. The pride comes out of the challenge; the reward is excellence in the work.

    FOR EASY APPLICATION USE OUR CAREER SITE LOCATED ON http://www.ProSidian.com/ OR SEND YOUR RESUME’S, BIOS, AND SALARY EXPECTATION / RATES TO CAREERS @ PROSIDIAN.COM.

    ONLY CANDIDATES WITH REQUIRED CRITERIA ARE CONSIDERED.

    Be sure to place the job reference code in the subject line of your email.  Be sure to include your name, address, telephone number, total compensation package, employment history, and educational credentials.

  • 3 Days Ago

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Sterile Processing Department Director
  • Clinical Management Consultants
  • Everett, WA FULL_TIME
  • An amazing career opportunity has just become available for a Director of Sterile Processing Department with a reputable, Magnet Designated Hospital in the Greater Seattle Area! This award-winning hos...
  • 17 Days Ago

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Senior Workers Compensation Claims Adjuster
  • TheBest Claims Solutions
  • Seattle, WA TEMPORARY
  • Senior Workers Compensation Claims Adjuster SEATTLE, WA 98039 | TEMPORARY $35.00 TO $40.00 PER HOUR, DEPENDING ON EXPERIENCE Job Description Our client, a national insurance company, is looking to add...
  • 8 Days Ago

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Complex Claims Director
  • Berkshire Hathaway Specialty Insurance
  • Seattle, WA FULL_TIME
  • Who are we? A strong, trusted insurance partner, Berkshire Hathaway Specialty Insurance (BHSI) provides a broad range of commercial property, casualty and specialty insurance coverages and outstanding...
  • 22 Days Ago

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Patient Support Medical Biller/Claims Processing Representative (Home-Based)
  • IQVIA INC (US10)
  • Seattle, WA FULL_TIME
  • As the only global provider of commercial solutions, IQVIA understands what it takes to deliver nationally and internationally. Our teams help biopharma, medical device and diagnostic companies get th...
  • 1 Month Ago

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Interim Leadership Manager / Director Sterile Processing Manager
  • Aya Healthcare
  • Everett, WA FULL_TIME,CONTRACTOR,TEMPORARY
  • Aya Healthcare has an immediate opening for the following position: Sterile Processing Manager Manager / Director in Everett, Washington. This is a 17-week contract position that requires at least one...
  • 6 Days Ago

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Director of Claims Quality
  • Tandym Group
  • Jersey City, NJ
  • A health services organization in New York City is currently seeking an experienced professional to join their staff as ...
  • 4/19/2024 12:00:00 AM

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Director of Claims Management
  • MoveUp Consulting
  • Wooster, OH
  • Job Description Job Description Job Title: Director of Claims Management Location: REMOTE - Wooster, OH Company: MoveUp ...
  • 4/18/2024 12:00:00 AM

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Managing Director - Construction Claims
  • LVI Associates
  • As the Managing Director of Construction Disputes / Claims, you will play a pivotal role in spearheading our clients eff...
  • 4/18/2024 12:00:00 AM

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Claims Director, Personal Injury Protection
  • Plymouth Rock Assurance
  • Woodbridge, NJ
  • The Personal Injury Protection (PIP) Claims Director provides business leadership and strong technical skills for the Cl...
  • 4/18/2024 12:00:00 AM

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Director of Claims
  • Masis Professional Group
  • Charlotte, NC
  • SUMMARY: Assists with the management of the claims department. Manages complex claim files and manages personnel in the ...
  • 4/17/2024 12:00:00 AM

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Director of Claims
  • Masis Professional Group
  • Charlotte, NC
  • SUMMARY: Assists with the management of the claims department. Manages complex claim files and manages personnel in the ...
  • 4/16/2024 12:00:00 AM

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Casualty Claims Director
  • Plymouth Rock Assurance
  • Boston, MA
  • Reporting directly to the Vice President of Claims of the Independent Agent Channel, the Director will oversee our MA an...
  • 4/16/2024 12:00:00 AM

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Casualty Claims Director
  • Plymouth Rock Assurance
  • Boston, MA
  • Reporting directly to the Vice President of Claims of the Independent Agent Channel, the Director will oversee our MA an...
  • 4/15/2024 12:00:00 AM

Washington (/ˈwɒʃɪŋtən/), officially the State of Washington, is a state in the Pacific Northwest region of the United States. Washington is the northwestern-most state of the contiguous United States. It borders Idaho to the east, bounded mostly by the meridian running north from the confluence of the Snake River and Clearwater River (about 116°57' west), except for the southernmost section where the border follows the Snake River. Oregon is to the south, with the Columbia River forming the western part and the 46th parallel forming the eastern part of the Oregon-Washington border. To the wes...
Source: Wikipedia (as of 04/17/2019). Read more from Wikipedia
Income Estimation for Claims Processing Director jobs
$170,982 to $229,767

Claims Processing Director in Cedar Rapids, IA
The Manager-Claims Process evaluates existing business processes, procedures, and results to identify variance, recommend best practices that ensure high quality/low cost outcomes, and gain alignment across the business.
January 22, 2020
Getting a clear picture of your claims processes is key to containing future costs.
December 23, 2019
Claims Processing Director in Salem, OR
To file a claim, you would need to call the claims department or stop by your local agent’s office.  Some insurance companies also accept claims filed over the Internet.  Regardless of how you submit the claim, the information required will be similar.
February 17, 2020
Claims Processing Director in Baltimore, MD
Officials said the advance work will allow the files to be assigned immediately to claims processors for a decision within 30 days.
February 21, 2020