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 Claims Manager manages appraisal and examination staff and processes. Assures timely and proper disposition of claims based on policy provisions. Additionally, 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 a director. The Claims Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. To be a Claims Manager typically requires 5 years experience in the related area as an individual contributor. 1-3 years supervisory experience may be required. Extensive knowledge of the function and department processes. (Copyright 2024 Salary.com)
9 - 12 Years Healthcare experience must
9 - 12 years of experience in US Healthcare Payor operation.
Including, 7-10 years of experience in managing teams,
Strong operational & people management skill with experience of handling minimum of 100 employees
Working & Team handling Experience in claim adjudication/ Payment integrity/Enrollment
Excellent communication & interpersonal skills; team oriented and strong consensus building
Advanced knowledge of MS Word, MS Excel and Data management
Ability to operate in a rapidly changing environment with a sense of urgency, and to develop and deploy changes positively
Demonstrated analysis and problem solving abilities
Strong organizational and time management skills
The ability to multitask and self-manage workday is crucial.
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