13 claim director jobs found

Overview: Under the direction of the Revenue Cycle Administrator, develop and deliver employee-training programs. Performs work under general supervision. Handles moderately complex issues and problems, and refers more complex issues to higher-level staff. Possesses solid working knowledge of subject matter. May provide leadership, coaching, and/or mentoring to a subordinate group. Responsibilities: Triage invoices and determine appropriate action andcomplete the process required to obtain reimbursement for alltypes of professional services by physicians and nonphysicianproviders maintaining timely claims submissionsand timely Appeals processes as defined by individualpayors. Resubmit insurance claims when necessary to theappropriate carrier based on each payor's specific processwith the knowledge of timelines. Research, respond and take necessary action to resolveinquiries from PSRs (Patient Service Reps), CashDepartment, Charge Review and Refund Departmentrequests. Follow-up...

Overview: Under the direction of the Revenue Cycle Administrator, develop and deliver employee-training programs. Performs work under general supervision. Handles moderately complex issues and problems, and refers more complex issues to higher-level staff. Possesses solid working knowledge of subject matter. May provide leadership, coaching, and/or mentoring to a subordinate group. Responsibilities: Triage invoices and determine appropriate action andcomplete the process required to obtain reimbursement for alltypes of professional services by physicians and nonphysicianproviders maintaining timely claims submissionsand timely Appeals processes as defined by individualpayors. Resubmit insurance claims when necessary to theappropriate carrier based on each payor's specific processwith the knowledge of timelines. Research, respond and take necessary action to resolveinquiries from PSRs (Patient Service Reps), CashDepartment, Charge Review and Refund Departmentrequests. Follow-up...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a dedicated Injury Examiner , you will be responsible to adjust complex bodily injury claims, UM/UIM, and small business claims to include confirming coverage, determining liability, investigating, evaluating, negotiating, and adjudicating claims in compliance with state laws and regulations. Responsible for delivering a concierge level of best-in-class member service through setting appropriate expectations, proactive communications, advice, and empathy. This role is remote eligible in the continental U.S....

Overview: FTE- 1.0 Mon-Fri 8:00 am - 5:00 pm   Provides direct supervision to staff responsible for financial counseling for inpatients, ambulatory surgical patients, and their guarantors. Responsibilities: Key Responsibilities Patient Financial Counseling: Secures appropriate socio-economic data for each account. Establishes and/or confirms medical record identification numbers and patient registration information. Conducts detailed financial screenings and analyses. Verifies insurance or other third-party coverage. Obtains necessary signatures and supporting documentation from patients and guarantors. Coordinates financial issues with internal and external departments. Resolves or refers non-financial patient concerns to the appropriate department or agency. Billing Coordination: Coordinates billing processes by assisting in the preparation and management of clean, accurate, and complete claims and bills for patients and third-party...

Overview: Position Summary This position is responsible for performing all registration functions, including the creation or confirmation of a medical record and/or account number. The role supports timely access to healthcare services by accurately collecting demographic, sponsorship or guardian information, insurance details, financial data, and statistical information from various sources, including patients, families, physicians, physician office staff, and government or county agencies. Responsibilities: Key Responsibilities Perform patient registration duties with accuracy and efficiency, ensuring correct creation or confirmation of medical records and account numbers. Expedite patient access to care by gathering complete and accurate demographic, insurance, financial, and clinical information. Reduce account receivables and support revenue cycle performance by following established guidelines, policies, and regulatory requirements to improve first-pass claim...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a Data Scientist II for Fraud, you will be responsible the development of machine learning models that improve USAA’s ability to detect and prevent fraud on credit card, debit card, check, deposit, digital payments, as well as in other areas such as claims and disputes. Strong candidates will be able to deploy the following work products and processes: Develop and continuously update internal fraud models in the transactions and payment space, demonstrating techniques ranging from statistics to highly...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a dedicated Sr. Injury Adjuster, you will work within defined guidelines and framework, responsible to adjust attorney involved moderately complex bodily injury claims to include confirming coverage, determining liability, investigating, evaluating, negotiating, defending, and settling claims in compliance with state laws and regulations. Accountable for delivering a concierge level of best in class member service through setting appropriate expectations, proactive communications, advice, and compassion. This...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity This hybrid role requires an individual to be in the office 3 days per week, after completing 6 months in office . This position can be based in our Tampa, FL office. Relocation assistance is not available for this position. Start Date: February 9th. As a dedicated Auto Adjuster, you will be responsible to adjust moderately complex auto insurance claims presented by or against our members to include the end-to-end claims process and settling claims in compliance with state laws and regulations. Within...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a dedicated Claims Litigation Manager- Auto , you will be responsible for managing moderately complex litigation arising out of the auto contract in compliance with state laws and regulations, to include creating strategy for defense or settlement, evaluating, negotiating, and collaborating with defense counsel to secure appropriate resolution. Accountable for delivering a concierge level of best in class member service through setting appropriate expectations, proactive communications, advice and empathy....

JOB DESCRIPTION ESIS Claims Representative - Workers' Compensation Location: Tampa, FL Work Schedule: Hybrid (3 days in office / 2 days remote) Are you ready to make a meaningful impact in the world of workers' compensation? Join ESIS, a leader in risk management and insurance services, where your unique skills and talents help create safer workplaces and support individuals during times of need. At ESIS, we are committed to providing exceptional service and innovative solutions, and we welcome passionate people from all backgrounds to be part of our dynamic team. If you're eager to advance your career in a collaborative environment that values integrity, growth, and belonging, explore our exciting workers' compensation roles and discover how you can contribute to a brighter future for everyone. Position Overview: Under direct supervision initially, you will perform customer service and claims functions while training to become a claims representative. You'll gain...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a dedicated Complex Auto Adjuster, you will adjust highly complex auto insurance claims presented by or against our members to include the end-to-end claims process and settling claims in compliance with state laws and regulations. Accountable for delivering best in class service, through setting appropriate expectations, proactive communications, advice, and empathy. We offer a flexible work environment that requires an individual to be in the office 3 days per week, after completing 3 months in office. This...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity Accountable for auto, property and/or other claims teams to deliver operational business results at scale. Responsible for member service, paying what we owe, controlling expenses, employee engagement, quality, operational risk and compliance across multiple operational areas. Sets operational goals and measures to achieve overall claims targets. Designs and implements claim’s strategies supporting enterprise objectives. Collaborates and influences P&C strategies coordinating with peers to affect P&C mission...

The Accounts Receivable Manager will lead a team of Accounts Receivable professionals, leveraging strategic thinking and strong analytical skills to optimize billing performance and support organizational growth. This individual will collaborate cross-functionally, represent the department in discussions with key stakeholders, and help guide the company through evolving billing requirements and system enhancements. Key Responsibilities: Lead the daily operations of the billing and accounts receivable team, ensuring timely and precise claim submissions, payment applications, and resolution of billing discrepancies. Manage billing activities for government-funded programs, including Medicare, Medicaid, and commercial payers, maintaining high standards of compliance and customer service. Develop and implement strategies to improve billing efficiency, reduce denials, and accelerate cash flow. Establish and uphold rigorous billing schedules and deadlines to maintain...