Director of Claims Operations

Job Summary

A company is looking for a Director of Claims Operations.

Key Responsibilities

• Manage and develop high-risk claims examiners and guide supervisory staff
• Review and standardize procedures to enhance efficiency and compliance with regulations
• Coordinate the handling of complex claims and assist with legal documentation and inquiries

Required Qualifications

• Bachelor's degree in business administration, Health Administration, or related field
• 10+ years of TPA experience overseeing the Claims function
• Strong leadership skills with the ability to mentor and coach team members
• Highly organized and process-oriented
• Strong knowledge of claims processing systems and regulatory requirements