Head of Claims

Job Summary

A company is looking for a Head of Claims to oversee claims operations and lead a team in a fast-paced environment.

Key Responsibilities:

• Lead and manage all functions related to health insurance claims, including processing, auditing, and appeals
• Supervise and mentor a team of claim processors, adjusters, and auditors, ensuring efficient resolution of claims
• Develop and implement operational workflows and quality assurance programs while monitoring claim trends for process improvements

Required Qualifications:

• Minimum of 5+ years of experience in health insurance claims management, preferably 10+ years
• Senior leadership experience at a Third Party Administrator (TPA)
• Deep knowledge of health insurance claims processing and regulatory requirements
• Experience managing and developing high-performing teams
• Bachelor's degree or equivalent work experience is preferred