Share Email Opening Apply Now
Title

Claims Director 

Description

Job Description: Claims Director

Summary: The Claims Director has overall responsibility for the Claims Department at Peak and eClusive. Under the direction of the Chief Executive Officer (CEO), the Claims Director leads and directs overall operations of the claims department. The Claims Director is responsible for leading daily claims operations while ensuring efficient, high-quality outcomes.

Essential Functions:

Planning and Performance Management

  • Participate in the development of a claims performance dashboard, and oversee the performance of the team
  • Ensure policies, procedures and formal delegations are in place to maintain effective coordination and control of claims activities
  • Ensure that service and product standards are in place and that programs and training are in place to ensure consistent achievement of targets
  • Regularly evaluate policies and procedures to ensure consistent application and effective operation
  • Evaluate and ensure overall quality of service delivery process
  • Recommend alternative strategies to improve effectiveness of claims operations
  • Establish measures and processes by which to collect, monitor, evaluate, and report on key performance indicators
  • Continually increase the use of data as a basis for making business decisions
  • Assist in the exploration and evaluation of in-house or purchased technology solutions for current and future business needs
  • Instill and reinforce an outstanding service culture
  • Take prompt and decisive corrective action when necessary to ensure achievement of financial, operational, quality and service goals for the department

Business Evolution and Process Improvement

  • Assist in the evaluation of department readiness and staff preparedness for business evolution and expansion
  • Identify, Prioritize and facilitate process improvement projects for department
  • Participate in all phases of project management to make certain that the objectives and are accomplished on time and within budget and that risks have been identified and properly mitigated
  • Facilitate workgroups to identify ways to increase quality and efficiency and business and operations processes
  • Assure effective communication as organizational changes are implemented

Supervision and Leadership

  • Provide direct reports with timely and constructive performance feedback
  • Ensure all direct reports are fully informed of operational objectives
  • Conduct regular meetings with direct reports to communicate priorities and coordination of activities

Supervisory Responsibility: Directly responsible for supervision of Claims Manager; overall responsibility for Claims Examiners/Analyst/Floats.

Travel: Flexibility to travel up to 30% of the time.

    Work Environment:

    • This job operates in a professional office environment with a conversational noise level
    • No substantial exposure to adverse environmental conditions is expected.
    • Moderate pressure to meet scheduled appointments and deadlines

    Supervised by: Peak Chief Executive Officer

     
    Position Requirements

    Knowledge, Skills and Abilities:

    • Educational requirements include a high school diploma; related college degree or MBA preferred; equivalent business experience may be considered in lieu of education
    • Minimum of ten years of experience in a Claims leadership role
    • Extensive experience in operations required
    • A forward-thinking personality capable of identifying areas for improvement
    • Decisiveness to take timely action to bring about the desired change
    • Creative, innovative, and entrepreneurial spirit with excellent business acumen
    • Capacity to oversee a complex operation, and the leadership skills to function as a mentor and coach
    • Outstanding communication skills with clarity of thought and the ability to express, advocate and defend views effectively both orally and in writing
    • Skilled in establishing and maintaining effective working relationships with clients, and staff at all levels
    • Skilled in evaluating business trends to modify strategies
    • Skilled in data analysis and problem solving using defined methodologies
    • Skilled in problem resolution; recommends suggestions to increase accuracy and/or efficiency
    • Ability to budget and forecast demand, revenues and expenses and control costs
    • Ability to set and meet high standards of service to develop a work force that embraces a culture of quality and service
    • Ability to continuously display personal integrity and exemplary ethical standards
    • Ability to function effectively, exert influence and gain consensus at all organizational levels, in both direct, matrix and consultative organizational relationships, with internal stakeholders as well as external constituents
    • Tolerance for, and the ability to perform well, in stressful and ambiguous situations
    • Ability to interpret and administer policies and procedures consistently and objectively
    • Ability and flexibility to work in a relatively unstructured environment in a rapidly growing, dynamic company
    • Ability to attract, train, manage and motivate a skilled team
    • Maintains safe working environment. Follow all Policies and Procedures and OSHA safety guidelines

    Physical Demands & Requirements:

    • Communicate by way of the telephone with participants, customers, vendors and staff
    • Operate a computer and other office productivity machinery, such as a calculator, copy machine, fax machine and office printer
    • Remain stationary for extended periods of time
    • Occasionally exert up to 20 pounds of force to lift, carry, push, pull or move objects
    • Visual acuity to perform activities such as identifying, inputting and analyzing data on a computer terminal and/or in hard copy
    • Occasional reaching to retrieve shelved items
    • Occasional bending/stooping

    #DICE

     
    Full-Time/Part-Time Full-Time  
    Shift  
    Position Claims Director  
    Post Internal Days 0  
    Number of Openings 1  
    Location Mediture - Eden Prairie, MN  
    About the Organization  
    EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.  
    Cell None Specified 

    HoursPerWk None Specified 

    supervisorUID None Specified 

    This position is currently accepting applications.

    Apply Now



    WE ALSO RECOMMEND

    Other Jobs Within Same Category
    Claims Examiner in St. Louis , Missouri
    Posted on: 10/9/2019
    [Apply Now]

    Claims Supervisor in St. Louis , Missouri
    Posted on: 10/9/2019
    [Apply Now]


    Other Jobs Within 60 Miles
    Senior Java Software Developer Full-Stack in Eden Prairie, MN
    Posted on: 10/2/2019
    [Apply Now]

    Software Developer (Java) Full-Stack in Eden Prairie, MN
    Posted on: 10/2/2019
    [Apply Now]

    Provider Network Specialist in Eden Prairie, MN
    Posted on: 10/1/2019
    [Apply Now]

    Provider Service Representative in Eden Prairie, MN
    Posted on: 9/27/2019
    [Apply Now]



     


     
    Click here for technical assistance.