Claims Management Duties & Responsibilities Utilize efficient workflow organization to improve departmental efficiencies while ensuring effective client response and diligent analysis of claims, with extensive experience in both commercial and personal lines Provide relevant administration and direction to multi-million dollar staff budgets, quality control, fraud investigations, and complex claims reviews, earning denial authority over high - level claims cases Identify and develop talent among team members with focused training efforts, performance reporting and analyses, and operational efficiency initiatives Deliver continuous assessment of work force, while furnishing oversight and guidance regarding effective service strategies and techniques, loss liability monitoring, and claim litigation assistance Develop and implement the marketing and sales efforts of customer service team while tracking progress versus established internal and external benchmarks, providing disciplinary actions when necessary Construct customer service and claims team through effective staff hiring to aid in efficient operations and execution, delegating important tasks / assigments to line supervisors while providing branch - level guidance Aid in strategic planning and capital budgeting based on improving operating efficiency and reducing service - related production losses, collaborating effectively with senior - level management Maintain a strong working knowledge of important industry topics, company programs and policies, and overall regulatory environment, including state - level responsibility for process changes in casualty / PIP Address important client and staff queries, resolving them in an expedited manner Lead through example with consistent work ethic, attitude and professio
Claims Management Duties & Responsibilities Utilize efficient workflow organization to improve departmental efficiencies while ensuring effective client response and diligent analysis of
claims, with extensive experience in both commercial and personal lines Provide relevant administration and direction to multi-million dollar staff budgets, quality control, fraud investigations, and complex claims reviews, earning denial authority over high - level claims cases Identify and develop talent among team members with focused training efforts, performance reporting and analyses, and operational efficiency initiatives Deliver continuous assessment of work force, while furnishing oversight and guidance regarding effective service strategies and techniques, loss liability monitoring, and claim litigation assistance Develop and implement the marketing and sales efforts of customer service team while tracking progress versus established internal and external benchmarks, providing disciplinary actions when necessary Construct customer service and claims team through effective staff hiring to aid in efficient operations and execution, delegating important tasks / assigments to line supervisors while providing branch - level guidance Aid in strategic planning and capital budgeting based on improving operating efficiency and reducing service - related production losses, collaborating effectively with senior - level management Maintain a strong working knowledge of important industry topics, company programs and policies, and overall regulatory environment, including state - level responsibility for process changes in casualty / PIP Address important client and staff queries, resolving them in an expedited manner Lead through example with consistent work ethic, attitude and professio
claims, with extensive
experience in both commercial and personal lines Provide relevant administration and direction to multi-million dollar staff budgets, quality control, fraud investigations, and complex
claims reviews, earning denial authority over high - level claims cases Identify and develop talent among team members with focused training efforts, performance reporting and analyses, and operational efficiency initiatives Deliver continuous assessment of work force, while furnishing oversight and guidance regarding effective service strategies and techniques, loss liability monitoring, and claim litigation assistance Develop and implement the marketing and sales efforts of customer service team while tracking progress versus established internal and external benchmarks, providing disciplinary actions when necessary Construct customer service and claims team through effective staff hiring to aid in efficient operations and execution, delegating important tasks / assigments to line supervisors while providing branch - level guidance Aid in strategic planning and capital budgeting based on improving operating efficiency and reducing service - related production losses, collaborating effectively with senior - level management Maintain a strong working knowledge of important industry topics, company programs and policies, and overall regulatory environment, including state - level responsibility for process changes in casualty / PIP Address important client and staff queries, resolving them in an expedited manner Lead through example with consistent work ethic, attitude and professio
claims reviews, earning denial authority over high - level
claims cases Identify and develop talent among team members with focused training efforts, performance reporting and analyses, and operational efficiency initiatives Deliver continuous assessment of work force, while furnishing oversight and guidance regarding effective service strategies and techniques, loss liability monitoring, and claim litigation assistance Develop and implement the marketing and sales efforts of customer service team while tracking progress versus established internal and external benchmarks, providing disciplinary actions when necessary Construct customer service and claims team through effective staff hiring to aid in efficient operations and execution, delegating important tasks / assigments to line supervisors while providing branch - level guidance Aid in strategic planning and capital budgeting based on improving operating efficiency and reducing service - related production losses, collaborating effectively with senior - level management Maintain a strong working knowledge of important industry topics, company programs and policies, and overall regulatory environment, including state - level responsibility for process changes in casualty / PIP Address important client and staff queries, resolving them in an expedited manner Lead through example with consistent work ethic, attitude and professio
claims cases Identify and develop talent among team members with focused training efforts, performance reporting and analyses, and operational efficiency initiatives Deliver continuous assessment of
work force, while furnishing oversight and guidance regarding effective service strategies and techniques, loss liability monitoring, and
claim litigation assistance Develop and implement the marketing and sales efforts of customer service team while tracking progress versus established internal and external benchmarks, providing disciplinary actions when necessary Construct customer service and
claims team through effective staff hiring to aid in efficient operations and execution, delegating important tasks / assigments to line supervisors while providing branch - level guidance Aid in strategic planning and capital budgeting based on improving operating efficiency and reducing service - related production losses, collaborating effectively with senior - level management Maintain a strong working knowledge of important industry topics, company programs and policies, and overall regulatory environment, including state - level responsibility for process changes in casualty / PIP Address important client and staff queries, resolving them in an expedited manner Lead through example with consistent work ethic, attitude and professio
claims team
through effective staff hiring to aid in efficient operations and execution, delegating important tasks / assigments to line supervisors while providing branch - level guidance Aid in strategic planning and capital budgeting based on improving operating efficiency and reducing service - related production losses, collaborating effectively with senior - level management Maintain a strong
working knowledge of important industry topics, company programs and policies, and overall regulatory environment, including state - level responsibility for process changes in casualty / PIP Address important client and staff queries, resolving them in an expedited manner Lead
through example with consistent
work ethic, attitude and professionalism
Director of Business — Duties & Responsibilities Recruit and train staff of 30 in hospital policies, procedures, best practices, and corporate branding Design and implement staff development, recognition, and disciplinary policies and procedures Oversee admissions, utilization review, PB X, imaging center, billing, collections, and wound center registrations Set and strictly adhere to departmental budgets and schedules Author and present financial reports concerning revenue, expenses, and outstanding collections Identify performance indicators and benchmarks for integration into reporting systems Conduct surveys regarding patient / staff satisfaction, benchmarks, accreditation, and employee benefits Maintain a 99 % patient satisfaction score
through attentive and professional standards of care Negotiate contracts and
claims with insurance carriers, Medicare, Medicaid, and other payer sources Increase revenue by 30 %
through effective contract renegotiation with suppliers, carriers, and other parties Implement policies, procedures, and equipment to cut hospital costs while enhancing patient care Utilize strong management
experience to drive operations in an efficient and professional manner Develop and implement billing controls, cash processing measures, lockboxes, and other financial processes Coordinate and oversee internal and external audits ensuring compliance with industry and legal standards Recruit physicians
through successful marketing, networking, and other tactics Implement automated Chargemaster financial application (Craneware) and maintain patient accounts Responsible for HCAHPS and the yearly Quality Assurance Plan Appeal
claims when appropriate resulting in $ 400,000 reimbursement from PPO insurance over the last year Build and strengthen professional relationship with community leaders, coworkers, and industry figures Consistently promoted for excellence in financial management, team leadership, and dedication to mission Develop
working knowledge of hospital operations from patient admission to senior level strategic planning Represent company with poise, integrity, and positivity