• Managing Director Complex Claims

    AIG (Atlanta, GA)
    …trial preparation and ultimate resolution claim closure. + Collaborate with insureds, third party administrators, underwriters, and brokers to ensure all ... customers to manage risk. Join us as a Managing Director Complex Claims to play your part...with claim handling and reporting guidelines. + Work with TPA Claims Financial to check the accuracy… more
    AIG (05/01/25)
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  • Sr. TPA Specialist, Complex Claims

    Zurich NA (Salem, OR)
    …regularly communicates with TPAs, customers, brokers, Business Unit Underwriters and representatives, TPA Operations , Claims Legal, Corporate Law, and Senior ... Sr. TPA Specialist, Complex Claims 125068 Zurich...Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-MD1 #LI- DIRECTOR #LI-REMOTE EOE Disability /… more
    Zurich NA (07/02/25)
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  • MassHealth Regulatory Compliance & Audits…

    Commonwealth Care Alliance (Boston, MA)
    …states will not be considered at this time._** Position Summary: Reporting to the Director , Claims Operations & Quality Assurance, the Regulatory Compliance ... CMS Medicare requirements. This role is housed within the Claims Operations & Quality Assurance team and...* 5+ years in healthcare compliance, regulatory affairs, or claims audit. * Experience working with TPA more
    Commonwealth Care Alliance (06/02/25)
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  • Workers Compensation Manager

    NDCP (Duluth, GA)
    …compensation lost time and medical only claims in an insurance company, third party administrator ( TPA ), or self-insured/high-deductible employer ... as the primary liaison in managing the Company's WC third - party administrator ( TPA ),...and accurate. + Communicate, as needed, with injured employees, third - party claims representatives, medical clinics,… more
    NDCP (07/12/25)
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  • Liability Manager

    Dollar Tree (Chesapeake, VA)
    …legal on high exposure or high severity claims to develop case strategy. * Direct Third Party Administrator ( TPA ) claims examiners and assign and ... interacts with internal and external legal counsel, insurance representatives, third party claims administrator... claims data to facilitate decisions on liability claims program structure and TPA staffing, direction… more
    Dollar Tree (07/02/25)
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  • Business Development Director - Casualty…

    Sedgwick (Salem, OR)
    …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Business Development Director - Casualty Claims (West Region) As a Business Development ... new client programs. + Develops the detailed knowledge of individual prospect operations targeting specific needs which may be opportunities for marketing company… more
    Sedgwick (06/29/25)
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  • Emory Health Plan, Vice President - Plan…

    Emory Healthcare/Emory University (Atlanta, GA)
    …RESPONSIBILITIES: + This role will be pivotal in managing the relationship with the third - party administrator ( TPA ) and ensuring efficient processes, ... and be the first point-of-contact for Emory HR. OVERSEE OPERATIONS : + Work with HR and TPA ...negotiate contracts (where necessary), and ensure quality of care. CLAIMS MANAGEMENT: + Oversee TPA claim processing,… more
    Emory Healthcare/Emory University (07/03/25)
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  • Director , Strategic Partnerships

    The Hartford (Hartford, CT)
    …partners, understanding their needs and expectations. + Conduct regular audits of TPA operations to ensure compliance with company standards and regulatory ... Vendors. + Identify and mitigate potential risks associated with TPA / Vendor operations . + Work with...Proven track record of effectively managing TPAs and improving claims handling processes. + Claims operations more
    The Hartford (07/11/25)
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  • Medicare/Medicaid Claims Editing Specialist

    Commonwealth Care Alliance (Boston, MA)
    …for One Year Term **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims ... Coding Sr. Analyst will be responsible for developing prospective claims auditing and clinical coding and reimbursement edits and necessary coding configuration… more
    Commonwealth Care Alliance (05/28/25)
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  • Director , Corporate Insurance & Risk…

    7-Eleven (Irving, TX)
    …management strategy. + Build, lead, and manage relationships with brokers, carriers, Third Party Administrators (TPAs), defense attorneys, and other external ... overseeing insurance programs to protect the company's assets and operations . The Director will manage relationships with...partners. + Oversee the TPA program, including vendor selection, program design, … more
    7-Eleven (06/27/25)
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