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Alternate job titles: Claims Process Operations Director

Oversees one or more departments responsible for inputting new insurance claims, processing payments, conducting billing research and responding to telephone inquires. Establishes and implements organizational policies and procedures; may offer guidance on the appropriate handling of complex or high-value claims. Develops and executes strategic business plans for the department. Coordinates operations with other areas of the organization. Typically requires a bachelor's degree of business administration. Typically reports to top management. Manages a departmental sub-function within a broader more...



Alternate job titles: Claims Service and Operations Director

Directs and oversees the operations of an insurance claims department to meet operation, financial, and service requirements. Provides guidance and sets policies on insurance claims for personal, property, or casualty loss based on coverage, appraisal, and verifiable damage. Responsible for the strategic processing and payment of claims. Keeps abreast of any changes to legislation and regulations which pertain to insurance claims. Provides guidance to subordinates on the most complex claims. Requires a bachelor's degree. Typically reports to top management. Manages a departmental sub-function more...


Alternate job titles: Claims Quality and Compliance Audit Director

Directs and oversees the operations of the claims quality audit department to follow the audit policies, procedures and regulation. Provides professional knowledge and guidance on technical or procedural problems. Creates claims audit policies and procedures. May recommend changes in claims processing procedures. Typically requires a bachelor's degree. Typically reports to top management. 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 f more...


Alternate job titles: Claims Tracking and Reporting Clerk

Responsible for inputting new claims, processing payments, conducting billing research and responding to telephone inquires. Determines whether to return, deny, or pay claims according to organizational policies and procedures. Reviews and dispositions claims. Prepares daily reports for claims management team. Requires a high school diploma or its equivalent. Typically reports to a supervisor. Possesses a moderate understanding of general aspects of the job. Works under the close direction of senior personnel in the functional area. May require 0-1 year of general work experience. more...



Alternate job titles: Claims Tracking and Reporting Senior Clerk

Responsible for inputting new claims, processing payments, conducting billing research and responding to telephone inquires. Reviews and dispositions more complex claims. Determines whether to return, deny, or pay claims according to organizational policies and procedures. Prepares daily reports for claims management team. May provide guidance to less experienced claims processors. Requires a high school diploma or its equivalent. Typically reports to a supervisor. Gains or has attained full proficiency in a specific area of discipline. Works under moderate supervision. Typically requires 1-3 more...


Alternate job titles: Claims Process Operations Supervisor

Supervises staff responsible for inputting new claims, processing payments, conducting billing research and responding to telephone inquires. Ensures the accurate and timely disposition of claims and resolves matters according to coverage amounts and company procedures. Provides guidance to junior staff on more complex or high-value claims. Provides technical support to staff that process claims. Typically requires a high school diploma or its equivalent. Typically reports to a manager. Supervises a small group of para-professional staff in an organization characterized by highly transactional more...



Alternate job titles: Claims Process Operations Manager

Manages staff responsible for inputting new claims, processing payments, conducting billing research and responding to telephone inquires. Ensures timely and proper disposition of claims in accordance with coverage amounts. Trains staff on organizational policies and ensures procedures are followed at all times. Provides guidance to junior staff on more complex or high-value claims. Typically requires a bachelor's degree of business administration. Typically reports to the head of a unit/department. Manages subordinate staff in the day-to-day performance of their jobs. True first level manager more...


Alternate job titles: Claims Clerk

The Claims Payment Processing Clerk determines claims coverage by examining company records. Reviews insurance claims forms and documents for accuracy and completion and obtains missing information as necessary. Being a Claims Payment Processing Clerk requires a high school diploma or its equivalent. Responsible for calculating claims amounts and submitting claims for payment. In addition, Claims Payment Processing Clerk typically reports to a supervisor. Being a Claims Payment Processing Clerk possesses a moderate understanding of general aspects of the job. Works under the close direction of more...


Alternate job titles: Claims Director

The Claims Service and Operations Director provides guidance and sets policies on insurance claims for personal, property, or casualty loss based on coverage, appraisal, and verifiable damage. Directs and oversees the operations of an insurance claims department to meet operation, financial, and service requirements. Being a Claims Service and Operations Director keeps abreast of any changes to legislation and regulations which pertain to insurance claims. Responsible for the strategic processing and payment of claims. In addition, Claims Service and Operations Director provides guidance to su more...



Alternate job titles: Claims Processing Director

The Claims Process Operations Director establishes and implements organizational policies and procedures; may offer guidance on the appropriate handling of complex or high-value claims. Oversees one or more departments responsible for inputting new insurance claims, processing payments, conducting billing research and responding to telephone inquires. Being a Claims Process Operations Director coordinates operations with other areas of the organization. Develops and executes strategic business plans for the department. In addition, Claims Process Operations Director typically requires a bachel more...


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