- AIG (Atlanta, GA)
- …trial preparation and ultimate resolution claim closure. + Collaborate with insureds, third party administrators, underwriters, and brokers to ensure all ... customers to manage risk. Join us as a Managing Director Complex Claims to play your part...with claim handling and reporting guidelines. + Work with TPA Claims Financial to check the accuracy… more
- AIG (Atlanta, GA)
- …we are reimagining the way we help customers to manage risk. Join us as a Complex Claims Director - TPA Oversight to play your part in that transformation. ... efficiency. How you will create an impact As Complex Claims Director - TPA Oversight,...Oversight, you will analyze and process bodily injury and third - party property damage claims by… more
- Commonwealth Care Alliance (Boston, MA)
- …states will not be considered at this time._** Position Summary: Reporting to the Director , Claims Operations & Quality Assurance, the Regulatory Compliance ... CMS Medicare requirements. This role is housed within the Claims Operations & Quality Assurance team and...* 5+ years in healthcare compliance, regulatory affairs, or claims audit. * Experience working with TPA … more
- NDCP (Duluth, GA)
- …compensation lost time and medical only claims in an insurance company, third party administrator ( TPA ), or self-insured/high-deductible employer ... as the primary liaison in managing the Company's WC third - party administrator ( TPA ),...and accurate. + Communicate, as needed, with injured employees, third - party claims representatives, medical clinics,… more
- Dollar Tree (Chesapeake, VA)
- …legal on high exposure or high severity claims to develop case strategy. * Direct Third Party Administrator ( TPA ) claims examiners and assign and ... interacts with internal and external legal counsel, insurance representatives, third party claims administrator... claims data to facilitate decisions on liability claims program structure and TPA staffing, direction… more
- Cambridge Health Alliance (Cambridge, MA)
- Director , Health Plan Operations - PACE Elder...systems. ** Claims and Revenue Reporting** * Oversee Third Party Administrator ( TPA ) ... supportive environment. **Position Overview** CHA PACE is seeking a strategic and detail-oriented ** Director of Health Plan Operations (HPO)** to lead and manage… more
- Sedgwick (Denver, CO)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Business Development Director - Casualty Claims (West Region) As a Business Development ... new client programs. + Develops the detailed knowledge of individual prospect operations targeting specific needs which may be opportunities for marketing company… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …RESPONSIBILITIES: + This role will be pivotal in managing the relationship with the third - party administrator ( TPA ) and ensuring efficient processes, ... and be the first point-of-contact for Emory HR. OVERSEE OPERATIONS : + Work with HR and TPA ...negotiate contracts (where necessary), and ensure quality of care. CLAIMS MANAGEMENT: + Oversee TPA claim processing,… more
- The Hartford (Hartford, CT)
- …partners, understanding their needs and expectations. + Conduct regular audits of TPA operations to ensure compliance with company standards and regulatory ... Vendors. + Identify and mitigate potential risks associated with TPA / Vendor operations . + Work with...Proven track record of effectively managing TPAs and improving claims handling processes. + Claims operations… more
- Commonwealth Care Alliance (Boston, MA)
- …considered at this time._** **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical ... 011250 CCA- Claims Hiring for One Year Term **_This position...on financial ability and forecasting for small to large Operations Management + Collaborate system and data configuration into… more
- Rexel USA (Dallas, TX)
- …compensation management across RHUSA + Daily Management of third - party administrator for all RHUSA workers compensation claims + Liaise with National ... Renewal negotiations + Daily liaison with adjusters and RHUSA Operations and Human Resources to troubleshoot claims ...in quarterly claim reviews and best practice audits with Third Party Administrator and other… more
- McLaren Health Care (Flint, MI)
- We are looking for a Director , MIG Operations , to join us in leading our organization forward. McLaren Integrated HMO Group (MIG) is a fully owned subsidiary of ... system configuration and maintenance. + Two (2) years' experience in payment integrity, claims editing and recovery operations . + Affiliation with a Professional… more
- 7-Eleven (Irving, TX)
- …management strategy. + Build, lead, and manage relationships with brokers, carriers, Third Party Administrators (TPAs), defense attorneys, and other external ... overseeing insurance programs to protect the company's assets and operations . The Director will manage relationships with...partners. + Oversee the TPA program, including vendor selection, program design, … more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …growth, with a strong emphasis on quality control and improvements to enhance claims processing stability, flexibility, and innovation. The Director will be ... related filed with minimum of 7 years' experience in Healthcare Payer or TPA setting. + Extensive background in understanding claims system configuration… more
- National Express (Lisle, IL)
- …incidents, completing on-scene investigations, and preparing/submitting corresponding reports to our third - party administrator ( TPA ) and develop ... new Safety Committees **.** + **Safety Oversight:** Work with the Area Safety Director and Operations Management to ensure company safety standards are deployed… more
- Johnson County Iowa (Iowa City, IA)
- …full month of employment. + Wellmark Blue Cross and Blue Shield of Iowa is the third party administrator for this self-funded plan + PPO with 90/10 ... general supervision of the Planning, Development, and Sustainability (PDS) Assistant Director , provides administrative support and performs work such as obtaining… more
- Perdue Farms, Inc. (Dillon, SC)
- …worker's compensation, assisting the occupational health nurse/ third party administrator in effectively managing all open claims . + Keeps the management ... production and garage safety in conjunction with the non-collocated safety director , safety for live production and garage/transportation operations … more
- Lowe's (Mooresville, NC)
- …outcomes and to identify gaps in the program. Works closely with LCNs, HR, Store Operations and claims administrator to close gaps and increase temporary ... You Will Do** + Evaluates monthly, quarterly, and annual performance of claims administrator and subcontracted vendors through analyses such as cost-benefit,… more
- Berkshire Hathaway Automotive (Irving, TX)
- …general liability, auto liability, and workers' compensation in coordination with outside third - party loss control personnel. * Involved in the organization's ... Automotive Headquarters in Irving, TX and report to the Director of Risk Management. Benefits: * Paid training and...the implementation of the risk solutions that help optimize operations . * Provide risk management consulting to assure compliance… more