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)
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.