Claims Operations Director

Job Summary

A company is looking for a Sr. Director, Claims Operations.

Key Responsibilities

• Lead and scale end-to-end claims operations, ensuring operational excellence and performance standards
• Identify and implement automation and workflow optimization initiatives to enhance efficiency
• Establish and oversee claims quality assurance and compliance programs

Qualifications

• Bachelor's degree in Healthcare Administration, Business, Finance, or related field required
• 10+ years of experience in health insurance claims operations
• 7+ years of leadership experience managing large claims teams
• Deep knowledge of health plan claims lifecycle and regulatory frameworks
• Experience with claims platforms and data analytics tools