• Managing Director TTPO Complex…

    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 TTPO Complex Claims to play your...with claim handling and reporting guidelines. + Work with TPA Claims Financial to check the accuracy… more
    AIG (05/01/25)
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  • Director , TPA & Dental Service…

    Medical Mutual of Ohio (Brooklyn, OH)
    …the development, implementation, and maintenance of multiple efficient and effective Third - Party Administrator ( TPA ) systems. **Responsibilities** ... capacity. . Demonstrated expert knowledge of all facets of Third - Party Administration medical, dental and specialty benefits, claims procedures, terminology,… more
    Medical Mutual of Ohio (05/03/25)
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  • Complex Claim Director - TPA

    AIG (Atlanta, GA)
    Complex Claims Director , TPA At AIG,...an impact + Analyze and process bodily injury and third - party property damage claims by investigating ... customers to manage risk. Join us as a Complex Claims Director to play your part in...with claim handling and reporting guidelines. + Work with TPA Claims Financial to check the accuracy… more
    AIG (04/24/25)
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  • Lead Director , Healthcare Insurance…

    CVS Health (Tallahassee, FL)
    …will do** **:** . Leads five different functional areas within Meritain, claims adjustments, recovery, FSA administration, front end mail, and data administration ... scope of approximately 160 employees. . Develops strategies to optimize service operations , ensuring the efficient and effective delivery of services to meet… more
    CVS Health (04/27/25)
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  • Claims Management Analyst, Technical…

    AIG (Atlanta, GA)
    …who provide technical claims oversight and handling of losses adjudicated by a Third - Party Administrator ( TPA ). They collaborate with TPAs and ... months. What you'll need to succeed + Experience with Claims Third Party Administrators preferred...career to the next level? If yes, the Complex Claims Director role may be for you.… more
    AIG (02/20/25)
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  • Director , Strategic Partnerships

    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
    The Hartford (04/11/25)
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  • Claims Leader, Property & Casualty

    HUB International (Columbus, OH)
    …full-time opportunity based in our Columbus office, and will report to the Director of Property & Casualty Operations . **ABOUT HUB INTERNATIONAL:** Overmyer Hall ... interactions and presentations + Provide and support clients with claims solutions specific to their business operations ...participate in claim reviews with multiple insurance carriers &/or TPA 's + Assist with marketing of claims more
    HUB International (04/11/25)
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  • Healthcare Medical Claims Coding Sr.…

    Commonwealth Care Alliance (Boston, MA)
    011250 CCA- Claims **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical ... Claims Coding Sr. Analyst will be responsible for developing prospective claims auditing and clinical coding and reimbursement edits and necessary coding… more
    Commonwealth Care Alliance (03/04/25)
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  • Director Risk Management

    Covenant Health (Bangor, ME)
    …closely with defense counsel and staff in all aspects of the captive claims management operations for St. Joseph Hospital-Bangor. Ensure timely investigations ... Job Summary The Director of Risk Management and Compliance is accountable...strategies to minimize them. Manage day-to-day risk management program operations at St. Joseph Hospital-Bangor. + Act as a… more
    Covenant Health (04/11/25)
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  • Director , Application Support and Quality…

    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
    Brighton Health Plan Solutions, LLC (04/19/25)
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  • Senior Director Product Development…

    Providence (Irvine, CA)
    …we have an unparalleled opportunity awaiting you! **The Role** As the Senior Director of Product Development, you will spearhead the successful growth and operation ... contact for employer clients, addressing issues related to access, network, claims administration, and performance. + **CRM Custodian:** Maintain an employer-based… more
    Providence (03/22/25)
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  • Business Development Director

    Sedgwick (Phoenix, AZ)
    …to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Business Development Director **PRIMARY PURPOSE** **:** Revenue growth of key accounts, new business ... + Focus on insurance carriers, brokers, agents, risk managers, MGA's, MGU's, TPA 's and similar accounts as directed + Facilitates the development of new… more
    Sedgwick (02/17/25)
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  • Manager of Data Analytics

    University of Michigan (Ann Arbor, MI)
    …job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are ... right time. MVC provides hospital and physician organization leaders with claims -based healthcare utilization data to empower local quality improvement activities.… more
    University of Michigan (05/02/25)
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  • Manager, Grievance and Appeals, RN

    VNS Health (Manhattan, NY)
    …at all levels including but not limited to, Provider Relations, Claims , Medical Director , third party administrator , pharmacy benefit manager, to ... dedicated Manager, Grievance and Appeals (RN)to lead the daily operations of our grievance and appeals processes. You will...analysis and reporting of grievances and appeals data for operations and for required CMS and DOH reporting. Participates… more
    VNS Health (03/05/25)
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  • Grievance & Appeals Specialist, Clinical

    VNS Health (Manhattan, NY)
    …health plan departments such as Claims and Medical Management, and the third party administrator staff and legal, as necessary, to investigate ... and accuracy standards are met. Coordinates efficient functioning of day-to-day operations according to defined processes and procedures. Creates and maintains… more
    VNS Health (02/07/25)
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  • Senior Manager - Corporate Insurance

    UGI Corporation (King Of Prussia, PA)
    …financial, and strategic risks. This role works in close collaboration with the Director , Risk and Corporate Insurance. + This role will help oversee insurance ... program management, claims handling, risk assessment, and relationship management with brokers...and the proper communication of case reserves to the TPA , Actuary and Accounting. + Coordinates the insurance programs… more
    UGI Corporation (04/28/25)
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  • Risk Manager

    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
    Berkshire Hathaway Automotive (03/17/25)
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