Job Category: Human Resources

Claims Director (BF)

Job Location: Morristown, NJ

Date Posted: 2020-01-23

The Claims Director is responsible for the daily oversight of the out-of-network services department including, but not limited to, staff management and quality of production against defined Key Performance Indicators.

RESPONSIBILITIES:
Manage and/or partner with the out-of-network service department. Handle all claims activity and train/coach employees. Manage any client issues including; provider disputes, claim processing issues, special requests, etc. Assist client and provider services departments, as needed. Work closely with client services and account management. Identify efficiencies and improve processes within the organizational structure of assigned departments. Identify and seek client approval to process specific claims according to recommendations which fall outside client’s normal services.

EXPERIENCE:
Bachelors Degree preferred. 8+ years’ experience claims processing. 4+ years’ management experience. Demonstrated expertise in processing and negotiating all out-of-network claims. Experience with both fully insured and self-insured markets.

Please contact Bryan Flynn at bflynn@clarkdavis.com

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