Regional 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 Regional Claims Manager manages appraisal and examination staff and processes. Assures timely and proper disposition of claims based on policy provisions. Additionally, Regional 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 top management. The Regional Claims Manager typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. To be a Regional Claims Manager typically requires 3+ years of managerial experience. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. (Copyright 2024 Salary.com)
```Job Overview```
We are seeking a highly skilled and experienced Claims Manager to join our team. As a Claims Manager, you will be responsible for overseeing the entire claims process and ensuring efficient and accurate handling of claims. This is a critical role that requires strong leadership, excellent communication skills, and a deep understanding of claims management.
```Responsibilities```
- Manage a team of claims adjusters and ensure they are meeting performance goals
- Develop and implement strategies to improve claims processing efficiency
- Review and analyze claims data to identify trends and areas for improvement
- Collaborate with other departments to resolve complex claims issues
- Ensure compliance with regulatory requirements and company policies
- Provide guidance and support to adjusters on complex or high-value claims
- Investigate potential fraud or suspicious activity related to claims
```Experience```
To be successful in this role, you should have the following experience and skills:
- Minimum of 10 years of experience in health and welfare benefit plan administration preferably in a multi-employer environment.
- Strong knowledge of insurance policies, procedures, and regulations
- Experience with ICD-9 coding or medical coding is preferred
- Excellent analytical and problem-solving skills
- Strong leadership abilities with the ability to motivate and inspire a team
- Exceptional communication skills, both written and verbal
If you are a highly motivated individual with a passion for claims management and have the required experience, we encourage you to apply for this position. We offer competitive compensation packages and opportunities for career advancement.
Please note that only qualified candidates will be contacted for further consideration.
Job Type: Full-time
Pay: $97,550.00 - $120,000.00 per year
Benefits:
Schedule:
Supplemental pay types:
Ability to Relocate:
Work Location: Hybrid remote in Dublin, CA 94568
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