Regional Claims Manager jobs in San Antonio, TX

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)

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Claims Manager
  • HealthTexas
  • San Antonio, TX FULL_TIME
  • Job Purpose
    The Claims Manager is responsible for overseeing and directing delegated Managed Care Claims adjudication and manage our medical claims department.
    In addition, you will be responsible for contributing to the growth and success of HealthTexas while upholding our Mission, Vision and Values.
    Culture and Values Expectations
    At HealthTexas, we believe that our workplace culture is the cornerstone of our success. We are committed to fostering an inclusive, collaborative, and innovative environment where every Associate feels valued, empowered and motivated to reach their full potential. Our culture is the driving force behind our mission “to deliver quality and compassionate care with outstanding service, every patient, every time”. As a Claims Manager at HealthTexas we expect you to embody and promote our Values and defined behavioral expectations.
    • Integrity: Do the right thing, the right way, every time.
      • Be honest and uphold commitments and responsibilities, earn the trust and respect of the team and those we serve, and maintain privacy and confidentiality.
    • Compassion: Treat everyone with respect and dignity.
      • Foster an environment of inclusivity and well-being, practice patience and empathy, and assume positive intent.
    • Synergy: Collaborate to improve outcomes.
      • Invite and explore new opportunities, promote effective communication and teamwork, take pride in yourself, your work and HealthTexas.
    • Stewardship: Use resources responsibly and efficiently.
      • Implement effective strategies to attain goals, achieve maximum productivity and results, and seek continuous knowledge and improvement.
    Essential Job Duties & Responsibilities
    • Participate in inter-departmental business activities, including input into budget preparation
    • Prepare inbound and outbound 835, 837, EFT, etc.
    • Encourage positive staff results by communicating job expectations; planning, monitoring, and appraising results; coaching, counseling, and implementing corrective action plans when necessary; developing, coordinating, and enforcing systems, policies, procedures, and productivity standards.
    • Complete performance evaluations in a timely manner.
    • Create, review, and/or update departmental procedures, workflows, and resource material.
    • Implement necessary policy and regulatory changes.
    • Develop and manage auditing and quality control standards.
    • Supervise the coordination of workflow and staffing of day-to-day activities as well as assigning and monitoring work of staff in order to adhere to productivity and quality standards to meet stated goals.
    • Manage delegated claims audit and reporting.
    • Ensure CMS and delegated claims compliance.
    • Resolve and/or gather appropriate guidance for any escalated issues.
    • Other duties, as assigned
    Experience
    • Minimum 5 years medical claims adjudication working experience, with at least 3 years of managerial experience
    • Medicare guidelines and healthcare claims regulation knowledge
    • Delegated Medicare Advantage Experience is required
    • Experience with claims adjudication software

    Education
    • Bachelor’s Degree preferred. In lieu of a degree, 6 or more years of relevant experience
    Knowledge, Skills & Abilities
    • Medicare guidelines and healthcare claims regulation knowledge
    Work Hours, Travel Requirements
    • Monday – Friday, 8:00 a.m. – 5:00 p.m., and as needed to complete projects.
    • Travel to medical offices may be necessary for the purpose of providing benefit education.

    Working Conditions & Physical Requirements
    • This job operates in an office setting. This role routinely uses standard office equipment such as computers, phones, photocopiers, scanners, filing cabinets and fax machines.
    • The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk and hear. This is largely a sedentary role; however, some filing is required. This would require the ability to lift files, open filing cabinets and bend or stand on a stool as necessary. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
  • 1 Month Ago

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Workers Compensation Claims Adjuster
  • TheBest Claims Solutions
  • San Antonio, TX OTHER
  • Workers Compensation Claims Adjuster SAN ANTONIO, TX 78201 | DIRECT HIRE $75,000 TO $83,000 ANNUALLY, DEPENDING ON EXPERIENCE Job Description Our client, a leading insurance company, is currently seek...
  • 20 Days Ago

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Automotive Claims Adjuster
  • Alternative Claims Management
  • San Antonio, TX FULL_TIME
  • Location: Remote (Texas, Florida, North Carolina, South Carolina, Michigan, Wisconsin, Georgia, Mississippi, Ohio) Hours: Monday to Friday 8:30 am - 5:00 pm WHO WE ARE We are a damage recovery expert ...
  • 1 Day Ago

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Claims Adjuster/Handler/Specialist (FT)
  • Alternative Claims Management
  • San Antonio, TX FULL_TIME
  • ***Hiring Soon***Location: REMOTE (Texas, Florida, North Carolina, Michigan, Wisconsin) Competitive Hourly Pay Performance-Based CommissionHours: Monday to Friday 8:30 am - 5:00 pm WHO WE ARE:We are a...
  • 18 Days Ago

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Medical Insurance Claims Manager
  • HealthTexas
  • San Antonio, TX FULL_TIME
  • Job PurposeThe Claims Manager is responsible for overseeing and directing delegated Managed Care Claims adjudication and manage our medical claims department.In addition, you will be responsible for c...
  • 1 Month Ago

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Regional Manager
  • Pico Propane and Fuels
  • San Antonio, TX FULL_TIME
  • The Regional Manager will manage the operations of our Eagleford Region. Duties include ensuring employees follow all federal, state, and local regulations pertaining to the storage, delivery, and usa...
  • 18 Days Ago

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0 Regional Claims Manager jobs found in San Antonio, TX area

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Insurance Biller
  • Smile Brands
  • San Antonio, TX
  • Overview: Smile Brands is a dominant player in the dental space and we are seeking an Insurance Biller to join our Reven...
  • 4/26/2024 12:00:00 AM

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Teacher's Aide/ Assistant Teacher
  • City of San Antonio, TX
  • San Antonio, TX
  • Salary: Depends on Qualifications Location : VARIOUS LOCATIONS ACROSS SAN ANTONIO, TX Job Type: 4A Full-Time Job Number:...
  • 4/26/2024 12:00:00 AM

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Property Adjuster - CAT (In Office)
  • United Services Automobile Association
  • San Antonio, TX
  • Why USAA? Let's do something that really matters! At USAA, we have an important mission: facilitating the financial secu...
  • 4/25/2024 12:00:00 AM

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Fleet / Safety Manager
  • Acuity International
  • San Antonio, TX
  • Our vision aims to empower our clients by actively leveraging our broad range of services. With our global presence, we ...
  • 4/24/2024 12:00:00 AM

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Reimbursement Business Advisor, Botox - San Antonio & Austin
  • AbbVie
  • San Antonio, TX
  • Company Description AbbVie's mission is to discover and deliver innovative medicines and solutions that solve serious he...
  • 4/24/2024 12:00:00 AM

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Field Property Claims Adjuster
  • Liberty Mutual Group
  • San Antonio, TX
  • You are here: / US,San Antonio-TX,Field Property Claims Adjuster **Field Property Claims Adjuster** **Field Property Cla...
  • 4/23/2024 12:00:00 AM

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Property Adjuster - CAT (In Office)
  • USAA
  • San Antonio, TX
  • Why USAA? Lets do something that really matters! At USAA, we have an important mission: facilitating the financial secur...
  • 4/22/2024 12:00:00 AM

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Nutrition Site Coordinator (Grant Funded) Part-Time
  • City of San Antonio, TX
  • San Antonio, TX
  • Salary: $19.07 Hourly Location : VARIOUS LOCATIONS ACROSS SAN ANTONIO, TX Job Type: 4C Part-Time Job Number: 2024-01158 ...
  • 4/22/2024 12:00:00 AM

San Antonio (/ˌsæn ænˈtoʊnioʊ/; from Spanish, "Saint Anthony"), officially the City of San Antonio, is the seventh-most populous city in the United States, and the second-most populous city in both Texas and the Southern United States, with more than 1.5 million residents. Founded as a Spanish mission and colonial outpost in 1718, the city became the first chartered civil settlement in present-day Texas in 1731. The area was still part of the Spanish Empire, and later of the Mexican Republic. Today it is the state's oldest municipality. The city's deep history is contrasted with its rapid rec...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Regional Claims Manager jobs
$151,677 to $212,428
San Antonio, Texas area prices
were up 1.2% from a year ago

Regional Claims Manager in Tucson, AZ
As a Regional Contract Claims Manager, located in our Broomfield, CO office, you will have responsibility for claims management within your assigned region.
December 13, 2019
Regional Claims Manager in Las Cruces, NM
Paul Martin of Colorado seek an unspecified amount of damages against defendants Shelly Reams, former administrator of the Wyoming Aeronautics Commission; members of the Cheyenne Regional Airport Board; Dave Haring, manager of the Cheyenne airport; and Great Lakes Aviation.
February 18, 2020
Regional Claims Manager in Passaic, NJ
Aligning performance of regional teams, to support delivery of the wider Third-Party Claims Targets & Objectives.
January 16, 2020