Medical Claims Supervisor
3 weeks ago
Job Summary:
The Claims Manager will be responsible for driving optimum claims outcomes, supporting operational goals and business objectives, and providing customer service to stakeholders. This position will oversee third-party adjusting (TPA) companies and work with adjusters on claims evaluations, strategy, reserves, and review.
Key Responsibilities:
- Manage all claims filed against the organization across various business units and insurance lines.
- Establish standardized procedures for filing, tracking, and resolving claims.
- Attend mediations as appropriate to provide expert representation and negotiation on behalf of the organization.
- Work closely with legal teams to develop strategies for effective claim resolution.
- Oversee and manage monthly invoices related to claims, ensuring accurate and timely processing of payments and reimbursements.
- Monitor and analyze financial data to identify cost-saving opportunities.
- Ensure all claims are managed in compliance with relevant laws and regulations.
Requirements:
- Bachelor's degree in a related discipline.
- 10+ years of experience as a claims adjuster for workers' compensation claims, auto claims, and general liability.
- Knowledge of insurance policies for determining coverage and limits.
- Familiarity with multi-jurisdictional adjusting and legal requirements.
- Experience with RMIS systems and general Microsoft software.
Equal Employment Opportunity:
J. B. Poindexter & Co. Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
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