claims operations manager

The Home Depot

<div>
 <p>
  <strong>
   Position Purpose:
  </strong>
 </p>
 <p>
  Responsible for defining, implementing, and managing internal claims programs (self-administration) to control quality and costs associated with premises and general liability claims (e.g. customer bodily injury and property damage). This position ensures the company&rsquo;s claims are handled internally in compliance with industry best practices and company policies, without reliance on a third-party administrator.
 </p>
 <p>
  <br/>
 </p>
 <p>
  <strong>
   Key Responsibilities:
  </strong>
 </p>
 <ul>
  <li>
   25% Claims Handling Standards - Develops and enforces claims handling standards and best practices and oversees quality assurance programs (e.g. file reviews and audits) to ensure adherence to those standards. Drives continuous improvement in claims processes and outcomes under the self-administration model.
  </li>
  <li>
   30% Claims Operations Management - Leads the day-to-day operations of a multi-line general liability claims unit, ensuring consistent application of departmental standards, policies, and procedures. Oversees claim intake, investigation, and resolution processes to maintain efficiency and compliance with service and quality benchmarks. Drives cost containment initiatives, including management of allocated expenses on claims. Monitors loss costs and implement strategies to reduce average claim costs while maintaining fairness and compliance (such as early resolution programs, subrogation efforts, etc.).
  </li>
  <li>
   10% Settlement Authority Oversight - Assumes oversight for all claim settlements and reserve decisions within designated authority levels &ndash; reviewing and approving settlements in accordance with company guidelines. Reviews written settlement evaluations and escalates to the appropriate approval level in the organization when required.
  </li>
  <li>
   10% Stakeholder Communication - Establishes clear interface guidelines and communication channels among all parties involved in claims, including the internal claims team (examiners/adjusters), store management, associates, and the Legal department. Regularly communicates claim status and trends to senior management and other stakeholders.
  </li>
  <li>
   25% Team Leadership - Manages and develops the in-house claims staff. Responsible for the selection, training, performance appraisal, and professional development of direct reports. Fosters a high-performance team culture and provides coaching and guidance to ensure adjusters meet regulatory requirements and company performance standards.
  </li>
 </ul>
 <p>
  <br/>
 </p>
 <p>
  <strong>
   Direct Manager/Direct Reports:
  </strong>
 </p>
 <ul>
  <li>
   This Position typically reports to Senior Claims Manager.
  </li>
  <li>
   This Position may have direct reports.
  </li>
 </ul>
 <p>
  <br/>
 </p>
 <p>
  <strong>
   Travel Requirements
  </strong>
  :
 </p>
 <ul>
  <li>
   Typically requires overnight travel 5% to 20% of the time.
  </li>
 </ul>
 <p>
  <br/>
 </p>
 <p>
  <strong>
   Physical Requirements:
  </strong>
 </p>
 <ul>
  <li>
   Most of the time is spent sitting in a comfortable position and there is frequent opportunity to move about. On rare occasions, there may be a need to move or lift light articles.
  </li>
 </ul>
 <p>
  <br/>
 </p>
 <p>
  <strong>
   Working Conditions:
  </strong>
 </p>
 <ul>
  <li>
   Located in a comfortable indoor area; any unpleasant conditions would be infrequent and not objectionable.
  </li>
 </ul>
 <p>
  <br/>
 </p>
 <p>
  <strong>
   Minimum Qualifications:
  </strong>
 </p>
 <ul>
  <li>
   Must be eighteen years of age or older.
  </li>
  <li>
   Must be legally permitted to work in the United States.
  </li>
  <li>
   Demonstrated supervisory and team management experience in the insurance claims field, with ability to mentor adjusters and implement efficient claims handling processes. Strong leadership abilities evidenced by building effective teams and improving workflow.
  </li>
 </ul>
 <p>
  <br/>
 </p>
 <p>
  <strong>
   Preferred Qualifications:
  </strong>
 </p>
 <ul>
  <li>
   Industry Knowledge: In-depth knowledge of casualty claims best practices, legal compliance (fair claims practices, state regulations), and claims quality control techniques (e.g. file audit and review programs). Capable of establishing and upholding rigorous standards for internal claims operation.
  </li>
  <li>
   Analytical &amp; Communication Skills: Excellent analytical and critical thinking skills to evaluate claim information and make sound decisions quickly. Effective negotiation and communication skills, enabling successful settlement negotiations and collaboration with internal and external stakeholders (customers, attorneys, insurers).
  </li>
  <li>
   Bachelor&rsquo;s degree in risk management, Insurance, Business, or related field preferred (or equivalent industry experience).
  </li>
  <li>
   Professional development in insurance claims or risk management (e.g. industry certifications) is a plus.
  </li>
 </ul>
 <p>
  <br/>
 </p>
 <p>
  <strong>
   Minimum Education:
  </strong>
 </p>
 <ul>
  <li>
   The knowledge, skills and abilities typically acquired through the completion of a high school diploma and/or GED.
  </li>
 </ul>
 <p>
  <br/>
 </p>
 <p>
  <strong>
   Preferred Education:
  </strong>
 </p>
 <ul>
  <li>
   The knowledge, skills and abilities typically acquired through the completion of a bachelor's degree program or equivalent degree in a field of study related to the job.
  </li>
 </ul>
 <p>
  <br/>
 </p>
 <p>
  <strong>
   Minimum Years of Work Experience
  </strong>
  :
 </p>
 <ul>
  <li>
   8
  </li>
 </ul>
 <p>
  <br/>
 </p>
 <p>
  <strong>
   Preferred Years of Work Experience:
  </strong>
 </p>
 <ul>
  <li>
   10
  </li>
 </ul>
 <p>
  <br/>
 </p>
 <p>
  <strong>
   Minimum Leadership Experience
  </strong>
  :
 </p>
 <ul>
  <li>
   3+ years of previous leadership experience
  </li>
 </ul>
 <p>
  <br/>
 </p>
 <p>
  <strong>
   Preferred Leadership Experience:
  </strong>
 </p>
 <ul>
  <li>
   5+ years of previous leadership experience
  </li>
 </ul>
 <p>
  <br/>
 </p>
 <p>
  <strong>
   Certifications:
  </strong>
 </p>
 <ul>
  <li>
   Insurance licensing as required by state
  </li>
 </ul>
 <p>
  <br/>
 </p>
 <p>
  <strong>
   Competencies:
  </strong>
 </p>
 <ul>
  <li>
   Decision Quality
  </li>
  <li>
   Collaborates
  </li>
  <li>
   Drives Engagement
  </li>
  <li>
   Ensures Accountability
  </li>
  <li>
   Plans and Aligns
  </li>
  <li>
   Communicates Effectively
  </li>
  <li>
   Customer Focus
  </li>
  <li>
   Develops Talent
  </li>
  <li>
   Drives Results
  </li>
  <li>
   Manages Conflict
  </li>
 </ul>
 <p>
 </p>
</div>


Claims Manager - Premises Liability

Reserv

<div><p><b>About Reserv</b></p><p>
Reserv is an insurtech creating and incubating cutting-edge AI and automation technology to bring efficiency and simplicity to claims. Founded by insurtech veterans with deep experience in SaaS and digital claims, Reserv is venture-backed by Bain Capital and Altai Ventures and began operations in May 2022. We are focused on automating highly manual tasks to tackle long-standing problems in claims and set a new standard for TPAs, insurance technology providers, and adjusters alike. We have ambitious (but attainable!) goals and need people who can work in an evolving environment. If building a leading TPA and the prospect of tackling the long-standing challenges of the claims role sounds exciting, we can't wait to meet you.</p><p></p><p><b><br>
About the role</b></p><p>
As the Major Case Unit Manager at Reserv you will be responsible for a team of high performing claims professionals handling Reserv's most complex and high exposure claims. We want your background and experience to deliver operational effectiveness, particularly in leveraging technology and analytics to drive better efficiencies and performance. You will serve a critical role with the team, the customers and the client. The high-performing team of Major Case Unit claim professionals you will manage will service a commercial ride share client. You will maintain high quality standards and in compliance with regulatory, internal and external contractual SLAs while working with some of the newest litigation technology. This position requires exceptional leadership skills and deep experience of compliance with state handling practices and transportation claims.</p><p></p><p><b><br>
What you'll do</b></p><ul><li>
Oversee a team of commercial auto adjuster direct reports</li><li>
Implement and maintain best practices for claims handling, including claim intake, investigation, evaluation, settlement, and recovery</li><li>
Align team with client and customer expectations of the claims process</li><li>
Serve as a resource for escalated claims</li><li>
Foster a positive work environment, promote teamwork, and encourage professional growth and development</li><li>
Attract, hire, retain, and provide a high level of training with the support of the rest of the leadership team</li><li>
Prepare and present comprehensive claims reports, metrics, and analyses to clients and customers; advise clients on claim trends and loss mitigation</li><li>
Serve as backup/ leader when the Manager is out of office</li><li>
Responsible for initial onboarding tasks/ access and new hire cultural immersion</li><li>
SME for first-line questions, escalations, roundtable discussions</li><li>
Increased reserve and payment authority with the ability to assist with moderate reviews</li><li>
Identify topics and trends to discuss in team Huddles and Elevated Claims Experience Workshops lead/ co-lead by Team Leads, Managers, and other Reserv employees</li></ul><p></p><p><b><br>
Qualifications</b></p><ul><li>
10+ years of insurance claims experience in multiple lines of business with litigated bodily injury experience</li><li>
5+ years of leadership experience with a preference for experience managing in a remote environment</li><li><b>
Experience with Ride Share (or TNC/Livery) litigation is required.</b></li><li>
Comfortable with technology and the ability to evolve the claims systems and processes to drive better efficiencies and outcomes</li><li>
Demonstrated commitment to quality, accuracy, and attention to detail</li><li>
Integrity, ethics, and a strong sense of accountability in handling confidential and sensitive information</li></ul><p></p><p><b><br>
Benefits</b></p><ul><li>
Generous health-insurance package with nationwide coverage, vision, &amp; dental</li><li>
401(k) retirement plan with employer matching</li><li>
Competitive PTO policy &ndash; we want our employees fresh, healthy, happy, and energized!</li><li>
Generous family leave policy after 8 months of continuous work</li><li>
Work from anywhere to facilitate your work life balance</li><li>
Apple laptop, large second monitor, and other quality-of-life equipment you may want. Technology is something that should make your life easier, not harder!</li></ul><p></p><p><b><br>
Additionally, we will</b></p><ul><li>
Listen to your feedback to enhance and improve upon the long-standing challenges of an adjuster and the claims role</li><li>
Work toward reducing and eliminating all the administrative work from an adjuster role</li><li>
Foster a culture of empathy, transparency, and empowerment in a remote-first environment</li></ul><p><br>
At Reserv, we value diversity in backgrounds, perspectives, and life experiences and believe that diversity in viewpoints and critical thinking drives innovation, first-principles thinking, and success. We welcome applicants from all backgrounds and encourage those from all walks of life to apply. If you believe you are a good fit for this role, we would love to hear from you!</p></div><p></p>

Major Case Unit Team Lead, Rideshare

USAA

<div><b>Location</b> San Diego, California; Las Vegas, Nevada; Sacramento, California; Seattle, Washington
<div><div><div><b>Job ID</b></div><div>
R0117324</div></div>
<div><div><b>Date posted</b></div><div>
05/07/2026</div></div>
</div><div><p><b>Why USAA?</b></p><p>
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.</p><p></p><p>
Embrace a fulfilling career at USAA, where our core values &ndash; honesty, integrity, loyalty and service &ndash; define how we treat each other and our members. Be part of what truly makes us special and impactful.</p><p></p><p>
We are proud to support active-duty military spouses. USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with applicable policy and business needs.</p><p></p><p><b>
The Opportunity</b></p><p></p><p>
As a dedicated <b>Manager, Claims Operations</b>, you will manage and be accountable for auto and other claims operations member service employees who are responsible for serving our members, and providing appropriate solutions as they investigate, evaluate and negotiate the claim. Develops engaged employees through regular coaching and feedback to deliver business results. Executes process improvements, provides feedback on the process and leads organizational process changes. Drives execution of operational risk management, regulatory compliance training, policies and, procedures.</p><p></p><p>
We are proud to support active-duty military spouses. USAA roles may offer <b>remote or hybrid flexibility </b>for active-duty military spouses consistent with applicable policy and business needs.</p><p></p><p><b>
This is a field-based role in the San Diego Metro, CA, Seattle, WA, Las Vegas, NV or Sacramento, CA area. Candidates who are willing and able to work in San Diego, Seattle, WA, Las Vegas, NV or Sacramento, CA to the San Diego Metro, CA, Seattle, WA, Las Vegas, NV or Sacramento, CA area are encouraged to apply. </b>Relocation assistance is <b>not</b> available for this position.</p><p></p><p><b>
What you&rsquo;ll do:</b></p><p></p><ul><li>
Inspects and reviews quality of claim files and provide feedback to employees as appropriate.</li><li>
Responsible for ongoing coaching and driving awareness so employees understand how their work and contributions support the overall claims and Enterprise strategies.</li><li>
Proactively identifies opportunities to improve operational effectiveness, member experiences and processes providing feedback to internal partners</li><li>
Creates conditions for success removes obstacles, leads and champions change.</li><li>
Achieves optimal productivity through managing workload volumes, staffing, training needs, and identifying and implementing appropriate solutions.</li><li>
Responsible for ongoing monitoring of work to ensure consistent execution of processes and adherence to guidelines and frameworks.</li><li>
Handles escalations and makes appropriate decisions based on the policy.</li><li>
Facilitates and guides employees through skill identification and developing for career progression Supports projects by serving as a subject matter expert.</li><li>
Hires, develops, and coaches claims employees for results delivery.</li><li>
Consistently coaches employees on claims handling and identifies opportunities to improve overall process and engagement</li><li>
Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.</li></ul><p></p><p><b>
What you&rsquo;ll have:</b></p><p></p><ul><li>
Bachelor&rsquo;s degree: OR 4 years of related experience (in addition to the minimum years of experience required) may be substituted in lieu of degree.</li><li>
6 years of progressive customer service, operational, military or leadership experience to include a minimum of 2 years of claims handling experience required with demonstrated proficiency.</li><li>
2 years of direct team lead, supervisory or management experience.</li><li>
Experience using and interpreting data to make decisions.</li><li>
Demonstrated leadership, initiative, customer service and/or claims handling skills.</li><li>
Acquisition and maintenance of applicable insurance adjuster license within 6 months time in role.</li></ul><p></p><p><b>
What sets you apart</b></p><p></p><ul><li>
5 years of property claims leadership experience.</li><li>
Experience leading and developing teams of adjusters ensuring quality, accuracy, and timely resolution of claims that will include high exposure/complex cases.</li><li>
Advanced knowledge of property claims contracts and interpretation.</li><li>
Residential construction experience.</li><li>
Subject Matter Expert in Verisk's complete suite of Property Estimating Solutions (e.g., Xactimate, ClaimXperience and XactAnalysis).</li><li>
Experience leading adjusters.</li><li>
Highly proficient in property claims process design and process improvement.</li><li>
CPCU or other insurance industry designations.</li><li>
Ability to work weekends and extended hours if needed.</li><li>
Reside within 50 miles of the Colorado Springs to Denver Metro, CO area.</li><li>
US military experience through military service or a military spouse/domestic partner.</li></ul><p></p><p>
The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.</p><p></p><p><b>
Compensation range:
</b></p><p>The salary range for this position is: $103,450 - $220,770<b>.</b></p><p></p><p><b>
USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.).
</b></p><p></p><p><b>Compensation:</b> USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.
</p><p></p><p>Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.</p><p></p><p>
The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.</p><p></p><p><b>
Benefits:</b> At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.</p><p></p><p>
For more details on our outstanding benefits, visit our benefits page on USAAjobs.com.</p><p></p><p><i>
Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.
</i></p><p></p><p><i>USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.</i></p></div></div>

Manager, Claims Operations- Complex Property Field Manager

M & M Fibers

<p><b>PRIMARY RESPONSIBILITIES</b></p><p>The Claims Manager is responsible for resolving all quality related claims fairly, professionally, providing outstanding service to all customers.</p><p><b>ESSENTIAL DUTIES AND RESPONSIBILITIES</b></p><p>1. Responsible for investigating and collecting all data related to claims. including invoices, samples, commissioning of independent inspectors, cleaners and lab testing.</p><p>2. Responsible for negotiating fair, accurate, and timely resolution of claims with lowest possible cost to the company.</p><p>3. Involve management and seek approval for claims exceeding the company authorized limit.</p><p>4. Coordinate the sale of goods that have been refused by dealers (reconsignment sales) to avoid return costs.</p><p>5. Responsible for filing, negotiating and tracking of charge backs to vendors for defective or damaged products.</p><p>6. Responsible for entering all mail, faxes and other communication daily into the claims system as received.</p><p>7. Other duties/special projects assigned by the Business Operations Manager.</p><p>8. Conduct communication with all customers, internal employees, vendors, and financial institutions in a professional manner, with integrity and a positive attitude.</p><p>9. Follow all published company policies and procedures.</p><p>Pay: $18.00 - $20.00 per hour</p><p>Benefits:</p><ul><li>401(k) 3% Match</li><li>Health insurance</li><li>Health savings account</li><li>Paid time off</li><li>Vision insurance</li></ul><p>Work Location: In person</p>

Claims Analyst

<div><p><b>About Reserv</b></p><p>
Reserv is an insurtech creating and incubating cutting-edge AI and automation technology to bring efficiency and simplicity to claims. Founded by insurtech veterans with deep experience in SaaS and digital claims, Reserv is venture-backed by Bain Capital and Altai Ventures and began operations in May 2022. We are focused on automating highly manual tasks to tackle long-standing problems in claims and set a new standard for TPAs, insurance technology providers, and adjusters alike. We have ambitious (but attainable!) goals and need people who can work in an evolving environment. If building a leading TPA and the prospect of tackling the long-standing challenges of the claims role sounds exciting, we can't wait to meet you.</p><p></p><p><b><br>
About the role</b></p><p>
As a Litigation Claims Team Lead, Rideshare at Reserv, you will be a working leader providing support to a claims manager with leadership and claim technical responsibilities. Leadership responsibilities will include overseeing adjusting staff doing work to service a commercial ride share client. We want your background and experience to deliver operational effectiveness, particularly in leveraging technology and analytics to drive better efficiencies and performance. You will serve a critical role with the team, the customers, and the client. This role will balance management responsibilities and individual contributor responsibilities when volume dictates the need for assistance with a claim.</p><p></p><p><b><br>
What you'll do</b></p><ul><li>
Oversee a team of commercial auto adjuster direct reports</li><li>
Implement and maintain best practices for claims handling, including claim intake, investigation, evaluation, settlement, and recovery</li><li>
Align team with client and customer expectations of the claims process</li><li>
Serve as a resource for escalated claims</li><li>
Foster a positive work environment, promote teamwork, and encourage professional growth and development</li><li>
Attract, hire, retain, and provide a high level of training with the support of the rest of the leadership team</li><li>
Prepare and present comprehensive claims reports, metrics, and analyses to clients and customers; advise clients on claim trends and loss mitigation</li><li>
Serve as backup/ leader when the Manager is out of office</li><li>
Responsible for initial onboarding tasks/ access and new hire cultural immersion</li><li>
SME for first-line questions, escalations, roundtable discussions</li><li>
Increased reserve and payment authority with the ability to assist with moderate reviews</li><li>
Identify topics and trends to discuss in team Huddles and Elevated Claims Experience Workshops lead/ co-lead by Team Leads, Managers, and other Reserv employees</li></ul><p></p><p><b><br>
Qualifications</b></p><ul><li>
10+ years of insurance claims experience in multiple lines of business with litigated bodily injury experience</li><li>
5+ years of leadership experience with a preference for experience managing in a remote environment</li><li><b>
Experience with Ride Share (or TNC/Livery) litigation is required.</b></li><li>
Comfortable with technology and the ability to evolve the claims systems and processes to drive better efficiencies and outcomes</li><li>
Demonstrated commitment to quality, accuracy, and attention to detail</li><li>
Integrity, ethics, and a strong sense of accountability in handling confidential and sensitive information</li></ul><p></p><p><b><br>
Benefits</b></p><ul><li>
Generous health-insurance package with nationwide coverage, vision, &amp; dental</li><li>
401(k) retirement plan with employer matching</li><li>
Competitive PTO policy &ndash; we want our employees fresh, healthy, happy, and energized!</li><li>
Generous family leave policy after 8 months of continuous work</li><li>
Work from anywhere to facilitate your work life balance</li><li>
Apple laptop, large second monitor, and other quality-of-life equipment you may want. Technology is something that should make your life easier, not harder!</li></ul><p></p><p><b><br>
Additionally, we will</b></p><ul><li>
Listen to your feedback to enhance and improve upon the long-standing challenges of an adjuster and the claims role</li><li>
Work toward reducing and eliminating all the administrative work from an adjuster role</li><li>
Foster a culture of empathy, transparency, and empowerment in a remote-first environment</li></ul><p><br>
At Reserv, we value diversity in backgrounds, perspectives, and life experiences and believe that diversity in viewpoints and critical thinking drives innovation, first-principles thinking, and success. We welcome applicants from all backgrounds and encourage those from all walks of life to apply. If you believe you are a good fit for this role, we would love to hear from you!</p></div><p></p>

Litigation Claims Manager, Rideshare

Assembly Talent

<div>
 Job Brief &ndash; Virtual Medical Manager
 <br/>
 <br/>
 Why work for us?
 <br/>
 <br/>
 Assembly Industries believes in creating a new generation of a passionate workforce in Pakistan by providing high-value opportunities that are life-changing. We strongly believe in a work-life balance and family-oriented approach to how we value the time &amp; effort of our employees. The core of our ethos is around passion, trust &amp; transparency. We offer the opportunity to collaborate with US-based clients in their growth phase. Working with us means direct engagement with top-tier CEOs, founders, and established businesses in the thriving US business ecosystem.
 <br/>
 <br/>
 Client Overview:
 <br/>
 <br/>
 Our client is a growing multi-specialty healthcare organization seeking an experienced Virtual Medical Manager to support billing operations, patient coordination, and overall practice efficiency. They are looking for a proactive and detail-oriented professional who can work across departments and ensure smooth day-to-day operations.
 <br/>
 <br/>
 Position Overview:
 <br/>
 <br/>
 We are looking for a highly organized and experienced Virtual Medical Manager to oversee medical billing processes, patient coordination workflows, and administrative operations across multiple specialties. The ideal candidate will work closely with internal teams, providers, and billing staff to ensure accuracy in claims processing, timely follow-ups, and efficient scheduling.
 <br/>
 <br/>
 This role requires a strong understanding of US healthcare systems, insurance workflows, and the ability to manage multiple operational functions in a remote environment.
 <br/>
 <br/>
 Responsibilities:
 <br/>
 <br/>
 <ul>
  <li>
   Manage end-to-end medical billing workflows, including claims submission, insurance follow-ups, and denial resolution
  </li>
  <li>
   Coordinate with providers, billing teams, and administrative staff to ensure accurate documentation and timely processing
  </li>
  <li>
   Oversee patient scheduling and coordination processes where required
  </li>
  <li>
   Review insurance verifications, prior authorizations, and ensure proper documentation is in place
  </li>
  <li>
   Monitor billing KPIs, collections, and aging reports to identify and resolve inefficiencies
  </li>
  <li>
   Communicate with insurance companies to resolve claim issues and reimbursement delays
  </li>
  <li>
   Maintain accurate records within EMR/EHR and billing systems
  </li>
  <li>
   Ensure compliance with US healthcare regulations and patient data privacy standards
  </li>
  <li>
   Collaborate with cross-functional teams to improve operational workflows and efficiency
  </li>
  <li>
   Provide support in onboarding and guiding junior team members when needed
   <br/>
   <br/>
  </li>
 </ul>
 Qualifications:
 <br/>
 <br/>
 <ul>
  <li>
   3+ years of experience in medical billing, healthcare operations, or practice management
  </li>
  <li>
   Strong understanding of US insurance processes, claims lifecycle, and reimbursement workflows
  </li>
  <li>
   Experience working with EMR/EHR systems and medical billing software
  </li>
  <li>
   Excellent communication skills (written and verbal)
  </li>
  <li>
   Strong analytical and problem-solving abilities
  </li>
  <li>
   Highly organized with the ability to manage multiple tasks and departments simultaneously
  </li>
  <li>
   Self-motivated and comfortable working in a remote environment
  </li>
  <li>
   High attention to detail, especially in billing accuracy and documentation
   <br/>
   <br/>
  </li>
 </ul>
 Preferred Qualifications:
 <br/>
 <br/>
 <ul>
  <li>
   Experience working in multi-specialty practices such as:
  </li>
  <ul>
   <li>
    Radiology
   </li>
   <li>
    Nephrology
   </li>
   <li>
    Cosmetic / Aesthetic practices
   </li>
   <li>
    Sports Injury / Rehabilitation
   </li>
   <li>
    Dental billing
   </li>
   <li>
    General medicine
   </li>
  </ul>
  <li>
   Familiarity with prior authorizations and insurance verification processes across specialties
  </li>
  <li>
   Knowledge of HIPAA compliance and patient confidentiality best practices
  </li>
  <li>
   Experience working with distributed or remote healthcare teams
   <br/>
  </li>
 </ul>
 This is a remote opportunity open to candidates in Pakistan.
 <br/>
 <br/>
 Your application includes a quick AI video interview.
 <br/>
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</div>


Virtual Medical Manager

Marriott International

<div><b>Additional Information</b><br>
<b>Job Number</b>26056861<br>
<b>Job Category</b>Finance &amp; Accounting<br>
<b>Location</b>Marriott International HQ, 7750 Wisconsin Ave, Bethesda, Maryland, United States, 20814<br>
<b>Schedule</b>Full Time<br>
<b>Located Remotely?</b>N<br>
<b>Position Type</b> Management<br>
<b>Pay Range:</b> $96,000-$151,900 annually<br>
<b>Bonus Eligible:</b> Y
<p></p><div><div><div><p><b>JOB SUMMARY</b></p></div><br>
<p></p><div><p>The Claims Unit Manager is responsible for overseeing the adjustment and resolution of self-insured and self-administered casualty claims across multiple jurisdictions, ensuring compliance with legal and organizational standards. This role manages a team of 3&ndash;6 claims professionals, including adjusters, assistants, and administrative support personnel, providing training, guidance, and performance oversight. The manager monitors caseloads to maintain appropriate balance based on jurisdictional requirements and the complexity of workers&rsquo; compensation and general liability claims, ensuring high-quality, timely, and cost-effective claim outcomes.</p></div><br>
<p></p><div><p><b>CANDIDATE PROFILE</b></p><br>
</div><p></p><div><p><b>Education and Experience
</b></p></div><div><p><i>Required</i></p>
</div><div><ul><li>Minimum of 5 years claims adjusting experience with advanced knowledge of claims processing.</li>
</ul></div><div><ul><li>Demonstrated experience providing technical guidance and direction, including litigation case management training and support.</li>
</ul></div><div><ul><li>Strong technical knowledge of civil laws and state workers&rsquo; compensation statutes.</li>
</ul></div><div><p><i>Preferred</i></p>
</div><div><ul><li>Bachelor&rsquo;s degree in risk management or claims
</li></ul></div><div><ul><li>Certification from various Claims seminars</li></ul><br>
</div><p></p><div><p><b>CORE WORK ACTIVITIES</b></p>
<div><ul><li>Maintain primary responsibility for settlement decisions up to individual authority.</li>
</ul></div><div><ul><li>Assign, control and monitor staff investigations/dispositions to assure compliance with state laws/regulations and department policies and procedures.</li>
</ul></div><div><ul><li>Monitor and approve benefit, claims and expense payments to assure reasonableness, accuracy and timeliness.</li>
</ul></div><div><ul><li>Review unit transactions to assure proper procedure and prompt error corrections.</li>
</ul></div><div><ul><li>Oversee and manage unit Service Call Program.</li>
</ul></div><div><ul><li>Monitor and assess adequacy of reserves.</li>
</ul></div><div><ul><li>Oversee and ensure the effective management of workers' compensation (WC) and liability claims by adjusters, in accordance with legal requirements and company policies. Key areas of focus include but are not limited to:</li>
</ul></div><div><ul><li>Prompt investigation of claims, including obtaining statements to determine liability and compensability.</li>
</ul></div><div><ul><li>Evaluation of damages and payment of benefits as prescribed by law and/or Marriott policies and procedures.</li>
</ul></div><div><ul><li>Collection of necessary documentation to support timely loss adjustment and oversight of settlement decisions within individual authority limits.</li>
</ul></div><div><ul><li>Completion and monitoring of timely WC payments and required state filings.</li>
</ul></div><div><ul><li>Management of WC medical treatment with the goal of minimizing disability, including consultation with Occupational Health Services as needed.</li>
</ul></div><div><ul><li>Oversight of litigation cases, including coordination with outside attorneys and support for discovery, trial preparation, and legal strategy.</li>
</ul></div><div><ul><li>Evaluation of claims for potential third-party liability or subrogation recovery.</li>
</ul></div><div><ul><li>Partner with the Regional Director and Operations Managers to ensure effective communication, coordination, and issue resolution across key operational areas, including:</li>
</ul></div><div><ul><li>Notifying leadership of staff absences, schedules, and appointments.</li>
</ul></div><div><ul><li>Informing of attorney, vendor, or other visits from external parties.</li>
</ul></div><div><ul><li>Communicating updates on upcoming trials and their outcomes.</li>
</ul></div><div><ul><li>Evaluating significant and high-risk incidents.</li>
</ul></div></div></div><div><div><ul><li>Reporting personnel issues or concerns as they arise.</li>
</ul></div><div><ul><li>Delivering monthly statistical reports within five days of receiving the data.</li></ul></div></div><p><br>
</p><p></p><p><i>Marriott International is an equal opportunity employer. We believe in hiring a diverse workforce and sustaining an inclusive, people-first culture. We are committed to non-discrimination on any protected basis, such as disability and veteran status, or any other basis covered under applicable law.</i></p><p></p><div>
All positions offer a 401(k) plan, stock purchase plan, discounts at Marriott properties, commuter benefits, employee assistance plan, and childcare discounts. Benefits are subject to terms and conditions, which may include rules regarding eligibility, enrollment, waiting period, contribution, benefit limits, election changes, benefit exclusions, and others. Click here to learn more.</div><div><br>
<br>
</div><div>Full-time positions also offer coverage for medical, dental, vision, health care flexible spending account, dependent care flexible spending account, life insurance, disability insurance, accident insurance, adoption expense reimbursements, paid parental leave and educational assistance.</div><div><br>
<br>
</div><div><b>Washington Applicants Only</b>: Employees will accrue paid sick leave, 0.077 PTO balance for every hour worked and be eligible to receive a minimum of 9 holidays annually.</div><div><br>
<br>
</div><div>Marriott HQ is committed to a hybrid work environment that enables associates to Be connected. Headquarters-based positions are considered hybrid, for candidates within a commuting distance to Bethesda, MD; candidates outside of commuting distance to Bethesda, MD will be considered for Remote positions.</div><p></p><p>
Marriott International is the world&rsquo;s largest hotel company, with more brands, more hotels and more opportunities for associates to grow and succeed. <b>Be</b> where you can do your best work, <b>begin</b> your purpose, <b>belong</b> to an amazing global team, and <b>become</b> the best version of you.</p></div></div>

Claims Unit Manager

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