Director, Claims

Job Description

Job Description

The Director, Claims oversees the activities of the Claims department to ensure appropriateness of all aspects of data entry/claims processing functions on a day to day basis. This is the standard adjudication and adjustment processes for a claims operation and will have 4 managers that report directly to them. This is a temporary position as the current Director is taking over the claim operations of a company they recently acquired.

Essential Functions: Direct and coordinate the activities of claims and data entry areas including direct supervision of subordinates and the implementation of employment issues • Maintenance of appropriate reimbursement levels, overseeing review of new procedure methodologies/research of payment mechanisms • Maintenance of a working knowledge of Management Information System and the coordination of required software enhancements for efficient claims processing • • Preparation and monitoring of departmental budget to control cost effectiveness • Assisting in the development and implementation of departmental policies and procedures • Assurance of appropriate level of staff training • Monitoring and documenting processing accuracy and productivity levels • Preparing and monitoring various reports as required • Perform any other job related instructions, as requested

Education and Experience: • Associate’s degree in business or related field or equivalent relevant work experience is required • Bachelor’s degree is preferred • Minimum of five (5) years of healthcare claims experience is required • Minimum of five (5) years of leadership experience is required

Insight Global is a purpose-driven staffing and professional services firm founded in 2001 and headquartered in Atlanta, GA. With a mission to empower people through opportunity, the company offers staffing, consulting, and workforce solutions across industries. What sets Insight Global apart is its deep commitment to personal, professional, and financial development—both for its internal team and the clients and consultants it serves. Their culture is built on values like high character, servant leadership, and taking care of one another

Company Description

Insight Global is a purpose-driven staffing and professional services firm founded in 2001 and headquartered in Atlanta, GA. With a mission to empower people through opportunity, the company offers staffing, consulting, and workforce solutions across industries. What sets Insight Global apart is its deep commitment to personal, professional, and financial development—both for its internal team and the clients and consultants it serves. Their culture is built on values like high character, servant leadership, and taking care of one another