auto rental liability litigation claims specialist

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manager - claims

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acute care transport, lead

auto rental liability litigation claims specialist Jobs in Atlanta

barista team lead

claims team lead

Reserv

<div><h3 class="jobSectionHeader"><b>About Reserv</b></h3><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.</p><p>
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&rsquo;t wait to meet you.</p><p></p><h3 class="jobSectionHeader"><b><br>
About the role</b></h3><p>
As a Claims Team Lead, Litigation 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 work done within the Commercial Auto Claims adjusting staff. 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><h3 class="jobSectionHeader"><b>
Who you are</b></h3><ul><li>
Highly motivated and growth-oriented, impactful and influential</li><li>
Claims professional - you are knowledgeable and have a track record of success in commercial auto claims adjudication.</li><li>
Strong leader - through formal management experience or a proven track record of peer and project leadership, you have demonstrated the ability to motivate, support, and teach a team to help them excel in their roles.</li><li>
Tech-oriented - You are excited by the prospect of building a tech-driven claims organization while delivering an excellent service and have proven results leveraging technology and analytics.</li><li>
Passionate - Claims professional who cares about their team, the customer, and their experience</li><li>
Empathetic leader - You exercise empathy and patience towards everyone you interact with</li><li>
Sense of urgency - at all times. That does not mean working at all hours</li><li>
Creative - You challenge existing assumptions and find ways of leveraging technology and the talents of your team to address problems</li><li>
Curious - You want to know the whole story so you can make the right decisions early and be decisive when it counts.</li><li>
Problem solver - You have the ability to take a &lsquo;deep dive&rsquo; into the details of the business while staying focused on the big picture.</li><li>
Anti-status quo - You don&rsquo;t just wish things were done differently; you act on it</li><li>
Communicative - You are comfortable with and understand the importance of phone communications throughout the claims process.</li><li>
And did we mention a sense of humor? Claims are hard enough as it is!</li></ul><h3 class="jobSectionHeader"><b>
What we need</b></h3><p>
We need you to do all the things typical to the role:</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><h3 class="jobSectionHeader"><b>
Requirements</b></h3><ul><li>
5+ years of insurance claims experience in multiple lines of business with bodily injury experience</li><li>
3+ years of leadership experience with a preference for experience managing in a remote environment</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><h3 class="jobSectionHeader"><b>
Benefits</b></h3><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>

Claims Team Lead Litigation

<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.</p><p>
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&rsquo;t wait to meet you.</p><p></p><p><b><br>
About the role</b></p><ul><li>
As a Team Lead 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 work done within the Commercial Auto Claims adjusting staff. 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.</li></ul><p><b>
Who you are</b></p><ul><li>
Highly motivated and growth-oriented, impactful and influential</li><li>
Claims professional - you are knowledgeable and have a track record of success in commercial auto claims adjudication.</li><li>
Strong leader - through formal management experience or a proven track record of peer and project leadership, you have demonstrated the ability to motivate, support, and teach a team to help them excel in their roles.</li><li>
Tech-oriented - You are excited by the prospect of building a tech-driven claims organization while delivering an excellent service and have proven results leveraging technology and analytics.</li><li>
Passionate - Claims professional who cares about their team, the customer, and their experience</li><li>
Empathetic leader - You exercise empathy and patience towards everyone you interact with</li><li>
Sense of urgency - at all times. That does not mean working at all hours</li><li>
Creative - You challenge existing assumptions and find ways of leveraging technology and the talents of your team to address problems</li><li>
Curious - You want to know the whole story so you can make the right decisions early and be decisive when it counts.</li><li>
Problem solver - You have the ability to take a &lsquo;deep dive&rsquo; into the details of the business while staying focused on the big picture.</li><li>
Anti-status quo - You don&rsquo;t just wish things were done differently; you act on it</li><li>
Communicative - You are comfortable with and understand the importance of phone communications throughout the claims process.</li><li>
And did we mention a sense of humor? Claims are hard enough as it is!</li></ul><p><b>
What we need</b></p><p>
We need you to do all the things typical to the role:</p><ul><li>
Flexibility - you will need to be able to switch from claims handling to coaching and feedback</li><li>
Agility- you must have an agile mindset and the ability to pivot from focus to focus in a moment&rsquo;s notice</li><li>
Be consistently dependable in achieving or exceeding goals and overcoming obstacles</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></ul><p><b>
Job Duties:</b></p><ul><li>
Serve as backup/leader when the Manager is out of office</li><li>
Responsible for having direct reports</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><li>
Customer Obsession Champions - Active advocates who help leadership cultivate a customer-centric mindset</li></ul><p><b>
Requirements</b></p><ul><li>
5+ years of insurance claims experience in multiple lines of business, preference for an auto with some bodily injury experience</li><li>
3+ years of leadership experience with a preference for experience managing in a remote environment</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><li>
Active adjuster license required: resident state license if available, otherwise a Designated Home State (DHS) license</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>

Claims Team Lead Auto Property Damage

Karna, LLC

<div>Description:
<p>
Karna is working to staff an immediate opening for a Claims Auditor in support of a CDC (Centers for Disease Control &amp; Prevention)/NIOSH (National Institute for Occupational Safety &amp; Health) contract. This position will offer a qualified candidate a great opportunity to work on a major public health project. If you meet the requirements of this announcement and possess the ability to work in a team environment as well as independently, please apply soon. Position is based in office and temporary to permanent.</p><p>
Responsibilities:</p><ul><li>
Ensure that all claims received are processed accurately and promptly in accordance with program guidelines</li><li>
Perform quality audits on claims adjudicated by claims processors and/or team leads</li><li>
Reviewing and addressing provider and customer inquiries externally and internally regarding claim adjudication</li><li>
Handling escalated, high dollar or complex claims for audit</li><li>
Developing and maintaining claims operations policies and procedures in the claims operations manual</li><li>
Resolving pended healthcare claims, prior approval requests and responding to providers</li><li>
Analyzing claims to determine whether or not the claims should be approved or denied for payment</li><li>
Applying knowledge of medical coding and various medical claims forms to the claims process</li><li>
Managing daily workflow for a team of processors, including training of new processors and ongoing updated operational processes</li><li>
Generating reports and analyzing the data using Microsoft Excel</li><li>
Auditing the work of claims processors</li><li>
Subject Matter Expert (SME) for claims processing and adjusting within and outside of the claims team</li></ul>
Requirements:
<ul><li>High School Diploma Required; Associate degree Preferred</li><li>
Requires excellent verbal and written communication skills</li><li>
Minimum of 5 years claims processing experience</li><li>
Must have prior experience working as a Team Lead or auditor</li><li>
Experience in a high-volume claims operations environment</li><li>
Microsoft Office skills, particularly Excel</li></ul></div>

Healthcare Claims Auditor

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 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

<div>
 Req170496
 <br/>
 <br/>
 <strong>
  Position Purpose
  <br/>
  <br/>
 </strong>
 Responsible for defining, implementing, and managing internal claims programs (self-administration) to control quality and costs associated with 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.
 <br/>
 <br/>
 <strong>
  Key Responsibilities
  <br/>
  <br/>
 </strong>
 <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.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Direct Manager/Direct Reports
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   This Position typically reports to Senior Claims Manager.
  </li>
  <li>
   This Position may have direct reports.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Travel Requirements
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Typically requires overnight travel 5% to 20% of the time.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Physical Requirements
  <br/>
  <br/>
 </strong>
 <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.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Working Conditions
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Located in a comfortable indoor area; any unpleasant conditions would be infrequent and not objectionable.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Minimum Qualifications
  <br/>
  <br/>
 </strong>
 <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.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Preferred Qualifications
  <br/>
  <br/>
 </strong>
 <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.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Minimum Education
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   The knowledge, skills and abilities typically acquired through the completion of a high school diploma and/or GED.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Preferred Education
  <br/>
  <br/>
 </strong>
 <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.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Minimum Years Of Work Experience
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   8
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Preferred Years Of Work Experience
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   10
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Minimum Leadership Experience
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   3+ years of previous leadership experience
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Preferred Leadership Experience
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   5+ years of previous leadership experience
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Certifications
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Insurance licensing as required by state
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Competencies
  <br/>
  <br/>
 </strong>
 <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>
</div>


Manager - Claims

MAG Mutual Insurance Company

<div>The Claims Analyst is responsible for investigating and managing primary litigation claims as assigned. This role involves developing a litigation plan and strategy with defense counsel, recommending defense or settlement strategies, and presenting cases to trial and settlement committees. This position assists management in the training of claims personnel and is responsible for completing special projects assigned by management. The Claims Analyst abides by MPL Analyst Guidelines.<div>
SPECIFIC DUTIES:</div><ul><li>
Establish and verify insurance coverage for MagMutual insured.</li><li>
Investigate claims against MagMutual insureds.</li><li>
Proper reserving and coding to accurately reflect exposure of MagMutual/insured.</li><li>
Assign a Medical Advisor when required.</li><li>
Thoroughly, accurately, and timely document case files</li><li>
Manage and control LAE expenses incurred on each assigned claim file.</li><li>
Determine the appropriate case plan - settlement or defense.</li><li>
Become knowledgeable and proficient in all claim management related technologies</li><li>
Timely close files</li><li>
Provide recommendations for continued use or termination of defense counsel/firms</li><li>
Handle specialty cases as needed.</li><li>
Lead committees as assigned by management.</li><li>
Assist with reports and communications with reinsurers.</li><li>
Assist with departmental and strategic projects.</li><li>
Become knowledgeable of all companies under the MagMutual Group and assists those companies in their growth when necessary.</li><li>
Attend continuing education seminars/courses to enhance medical/legal knowledge.</li></ul><div></div><div>
QUALIFICATIONS, EXPERIENCE REQUIRED:</div><ul><li>
College undergraduate degree</li><li>
Minimum four years of prior casualty claims experience with emphasis on medical malpractice claims.</li><li>
Experience handling high exposure cases including negotiations/resolution.</li><li>
Excellent communication, interpersonal, analytical, and negotiation skills.</li><li>
Ability to project a professional demeanor.</li><li>
Ability to properly handle confidential information.</li><li>
Flexibility to travel as the position requires.</li></ul><div></div><div>
JOB REPORTS TO:</div><ul><li>
Claims Team Lead</li></ul><div>
Location:</div><div></div>
Atlanta Office</div>

Claims Analyst

Rialtic, Inc.

<div><h3 class="jobSectionHeader"><b>Role Overview</b></h3>
<h4 class="jobSectionHeader"><b>The Senior Manager, Claims Analytics, leads the claims analytics function within the Implementation organization. This role is responsible for overseeing complex reimbursement and payment accuracy analyses, managing analysts, setting analytical standards, and partnering cross-functionally with GTM, Customer Success, Product, and Engineering teams to ensure successful client implementations.</b></h4>
<h4 class="jobSectionHeader"><b>This role combines deep healthcare claims expertise with people leadership, strategic thinking, and operational execution to scale analytics capabilities and drive measurable financial outcomes for clients.</b></h4>
<h3 class="jobSectionHeader"><b>Key Responsibilities</b></h3>
<h4 class="jobSectionHeader"><b>Leadership &amp; Strategy</b></h4>
<ul><li><h4 class="jobSectionHeader"><b>Lead and mentor a team of Implementation Claims Analysts, setting priorities, performance expectations, and development plans. Define and standardize analytical methodologies, reporting frameworks, and best practices for claims and reimbursement analysis.</b></h4>
</li><li><h4 class="jobSectionHeader"><b>Partner with Implementation leadership to align analytics deliverables with client goals, timelines, and success metrics.</b></h4>
</li><li><h4 class="jobSectionHeader"><b>Act as a subject-matter expert in claims analytics for complex or high-visibility client implementations.</b></h4>
</li></ul><h4 class="jobSectionHeader"><b>Analytics &amp; Execution</b></h4>
<ul><li><h4 class="jobSectionHeader"><b>Oversee large-scale analysis of claims data related to charge capture, reimbursement, underpayment, overpayment, and payment accuracy.</b></h4>
</li><li><h4 class="jobSectionHeader"><b>Ensure the delivery of exception-driven, actionable insights that clearly identify systemic versus isolated issues.</b></h4>
</li><li><h4 class="jobSectionHeader"><b>Review and validate analytical outputs, ensuring accuracy, consistency, and clarity in reporting and client-facing deliverables.</b></h4>
</li><li><h4 class="jobSectionHeader"><b>Guide analyses related to:</b><br>
</h4>
</li><li><ul><li><h4 class="jobSectionHeader"><b>Payor reimbursement behavior and trends</b></h4>
</li><li><h4 class="jobSectionHeader"><b>RVU productivity and payment alignment</b></h4>
</li><li><h4 class="jobSectionHeader"><b>Revenue cycle optimization opportunities</b></h4>
</li><li><h4 class="jobSectionHeader"><b>Financial performance to benchmarks, goals, and norms</b><br>
</h4>
</li></ul></li></ul><h4 class="jobSectionHeader"><b>Cross-Functional Collaboration</b></h4>
<ul><li><h4 class="jobSectionHeader"><b>Partner with GTM and Customer Success teams to support implementations, renewals, and expansion opportunities through analytics insights.</b></h4>
</li><li><h4 class="jobSectionHeader"><b>Collaborate with Product and Engineering teams to influence roadmap priorities based on claims analysis findings and client needs.</b></h4>
</li><li><h4 class="jobSectionHeader"><b>Serve as a senior analytics representative in client-facing discussions, executive readouts, and strategic reviews.</b><br>
</h4>
</li></ul><h4 class="jobSectionHeader"><b>Technical Oversight</b></h4>
<ul><li><h4 class="jobSectionHeader"><b>Guide data ingestion and processing pipelines using SQL*Loader, Oracle, shell scripting, and cloud-based tools.</b></h4>
</li><li><h4 class="jobSectionHeader"><b>Oversee advanced analytics leveraging </b><b>SQL, PL/SQL, Python, Scala, Spark, and AWS</b><b>.</b></h4>
</li><li><h4 class="jobSectionHeader"><b>Ensure scalable, repeatable approaches to analyzing </b><b>billions of claims records</b><b> across clients.</b><br>
</h4>
</li></ul><h4 class="jobSectionHeader"><b>Required Qualifications</b></h4>
<ul><li><h4 class="jobSectionHeader"><b>8+ years of experience in healthcare claims analytics, payment accuracy, or reimbursement analysis.</b></h4>
</li><li><h4 class="jobSectionHeader"><b>Prior experience working with claims editing or payment accuracy vendors.</b></h4><b>
</b></li><li><h4 class="jobSectionHeader"><b>Strong expertise in medical coding, billing guidelines, and reimbursement methodologies.</b></h4><b>
</b></li><li><h4 class="jobSectionHeader"><b>Proven people leadership experience managing and developing analytics teams.</b></h4><b>
</b></li><li><h4 class="jobSectionHeader"><b>Advanced proficiency in SQL and experience working with large healthcare datasets.</b></h4><b>
</b></li><li><h4 class="jobSectionHeader"><b>Strong executive communication and presentation skills.\</b></h4></li></ul></div><p></p>

Claims Analytics Manager

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