Top 49 Senior claims adjuster Jobs in Downers Grove Il

Sr. Manager Claims (Remote)
American Medical Association —Chicago, IL
- $104,872 - $138,737 a year
- Remote
- 7 years
- Writing skills
- HIPAA
- Disability insurance
Workers' Compensation Senior Claim Representative
The Hartford —Naperville, IL
- $62,400 - $93,600 a year
- Full-time
- Hybrid work
- Microsoft Outlook
- Customer service
- Computer literacy
Senior Property 1099 Field Adjuster (Illinois)
Infinity Insurance Services, LLC —Illinois
- $40 - $80 an hour
- Contract
- Background check
- Up to 50% travel
- 5 years
Quick Apply
1d
Senior Workers' Compensation Claims Specialist
CorVel Corporation —Downers Grove, IL
- $61,053 - $98,334 a year
- Full-time
- Hybrid work
- Customer service
- Computer literacy
- Mid-level
- Health savings account
- Disability insurance
Quick Apply
Senior Workers Compensation Claims Adjuster - IL/IA
Gallagher Bassett —Rolling Meadows, IL
- $74,000 - $106,000 a year
- Remote
- 3 years
- High school diploma or GED
- Analysis skills
Senior Claims Specialist II
Liberty Mutual —Hoffman Estates, IL
- $75,000 - $140,000 a year
- Full-time
- Hybrid work
- Mid-level
- Office
- Bachelor's degree
15h
Senior Claims Manager
AmericanAg® —Schaumburg, IL
- $165,000 - $190,000 a year
- Hybrid work
- Office
- 8 years
- Analysis skills
Quick Apply
Senior Claims Specialist - Professional Liability - Non-Profit D&O
Berkley —Naperville, IL
- $135,000 - $155,000 a year
- Full-time
- Hybrid work
- Office
- Analysis skills
- Bachelor's degree
- Profit sharing
- Health insurance
Senior Casualty Claims Specialist, Attorney Represented - Central Time Zone
Liberty Mutual —Chicago, IL
- $61,000 - $126,000 a year
- Full-time
- Mid-level
- Bachelor's degree
- Experience equivalent to degree accepted
Sr. Claim Representative/Claim Consultant
The Hartford —Naperville, IL
- $62,400 - $127,200 a year
- Full-time
- Hybrid work
- Microsoft Excel
- 5 years
- Office
Senior Claims Examiner, Misc. Professional Liability
Markel Service Inc. —Rosemont, IL
- $78,000 - $107,250 a year
- Email
- Writing skills
- Travel
- US work authorization
- AD&D insurance
- Employee stock purchase plan
Quick Apply
2d
Sr Ability Analyst - Absence Management
The Hartford —Naperville, IL
- $48,071 - $72,107 a year
- Full-time
- Hybrid work
- Customer service
- Office
- High school diploma or GED
- Disability insurance
10d
Senior Manager, Construction Claims
Markel Service Inc. —Rosemont, IL
- $118,960 - $163,570 a year
- Email
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- Customer service
- AD&D insurance
- Employee stock purchase plan
Quick Apply
Senior Claims Director-Commercial Direct Handle
Chubb —Chicago, IL
- $107,800 - $156,200 a year
- Full-time
- Travel
- Senior level
- Commercial
Senior Claims Specialist
Liberty Mutual —Hoffman Estates, IL
- $67,000 - $126,000 a year
- Full-time
- Office
- 3 years
- Bachelor's degree
3d
Casualty Claims Senior Specialist
HDI Global Insurance Company —Chicago, IL
- $130,000 - $140,000 a year
- Background check
- 5 years
- Pass drug screening
- Wellness program
- Commuter assistance
Quick Apply
Senior Technical Claim Manager-Miscellaneous Professional Liability/Errors & Omissions (E&O) (hybrid)
RLI Corp —Chicago, IL
- $115,778 - $168,746 a year
- Full-time
- 5 years
- Writing skills
- Bachelor's degree
- Profit sharing
- Health savings account
10h
Senior Workers' Compensation Claims Examiner - Federal Claims
AIG Claims, Inc. —Chicago, IL
- $73,000 - $96,000 a year
- Email
- Customer service
- Writing skills
- Office
- Health insurance
Quick Apply
Senior Claims Specialist
Westfield Insurance —Chicago, IL
- Full-time
- Hybrid work
- Microsoft Excel
- 6 years
- Microsoft Outlook
Senior Property Adjuster - Chicago, IL
Engle Martin and Associates, LLC. —Warrenville, IL
- Full-time
- Microsoft Word
- Customer service
- Research
Quick Apply

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Sr. Manager Claims (Remote)

American Medical Association -
Chicago, IL

Apply Now

Job Details

$104,872 - $138,737 a year

Benefits

Disability insurance

Qualifications

Staff supervision
Confidential information handling
HIPAA compliance
Team leadership
Writing skills
Presentations for conferences or internal meetings
HIPAA
Medical claims processing software
High school diploma or GED
Team development
ICD-9
ICD-10
HCPCS
Managing insurance claims teams
Medical terminology

Full Job Description

Sr. Manager Claims (Remote)

FL, IL, IN and WI

AMA Insurance (AMAI) offers life, health and disability insurance at affordable and exclusive rates to help doctors achieve a healthy and secure financial future. AMAI is part of the American Medical Association (AMA), a nonprofit, and the nation's largest professional Association of physicians. We are a unifying voice and powerful ally for America's physicians, the patients they care for, and the promise of a healthier nation. To be part of the AMA is to be part of our Mission to promote the art and science of medicine and the betterment of public health.

At AMA, our mission to improve the health of the nation starts with our people. We foster an inclusive, people-first culture where every employee is empowered to perform at their best. Together, we advance meaningful change in health care and the communities we serve.

We encourage and support professional development for our employees, and we are dedicated to social responsibility. We invite you to learn more about us and we look forward to getting to know you.

We have an opportunity for a remote Sr. Manager Claims on our AMA Insurance team. This role will manage AMA Insurance Claims Department by establishing claims polices and managing all claims related data, processes and procedures for AMA Insurance. Responsible for the timely and accurate processing of claims, ensuring adherence to all carrier requirements and federal/state regulations.. Serves as Agency subject matter expert and primary point of contact for all claims related functions; working closely with internal and external business partners. Responsible for process improvement and the development and utilization of key processing metrics. Manages team of claims processors.

RESPONSIBILITIES:

Compliance

Ensures AMAI remains in compliance with all claims related processing; must adhere to all carrier and/or state regulatory requirements with regards to timeliness, accuracy, and payments.
Leads annual carrier claims audits for Agency. This includes gathering files/information, communicating findings, and working directly with carrier audit team to resolve implement any required changes. Communicates findings with Agency senior management.
Responsible for periodic regulatory updates required on a state level. Collaborates with Legal to understand changes and then responsible for updating processes.
Responsible for accurately calculating benefits, benefit periods and interest calculations associated with claims payments as defined by carrier requirements.
Manages the internal AMAI claims review program; develops AMAI response on Claims reviews, complaints, and appeals; includes necessary research and coordinating with Legal and Leadership as needed.
Develops and implements processing changes as needed.

Claims Workflow Management

Responsible for the development, implementation and management of procedures and workflows to ensure AMAI meets all claims handling and compliance requirements throughout the entire claim life cycle.
Performs workload balancing daily based on incoming claims volumes and staff capacity.
Continually reviews team performance metrics to identify any process or quality gaps based on claims department goals and carrier Service Level Agreements.
Develops claims data reporting and workflow monitoring reports as needed to gain deeper insight into processing performance; results to drive process improvements.
Leads Claims and Customer Service team response when handling complex customer service matters.
Manage error resolution process (ex. issues with data file transfers), coordinating between AMAI IT and vendors (as needed) to identify, fix, and if needed, update processes to prevent errors from recurring.

Relationship Management

Act as a primary contact on claims related topic with partner carriers claims and compliance departments (including management teams); serves as an internal subject matter expert in both AMAI processes and claims regulations.
Manages the relationships with claims process vendors; includes negotiating terms/pricing, leading problem resolution with vendor and/or AMAI IT; coordinating updates to processes, and providing expert opinions.

Staff Management

Lead, mentor, and provide management oversight for staff.
Responsible for setting objectives, evaluating employee performance, and fostering a collaborative team environment.
Responsible for developing staff knowledge and skills to support career development.

May include other responsibilities as assigned

REQUIREMENTS:

1. Bachelor's degree preferred or equivalent work experience and HS diploma/equivalent education required.

2. 7+ years experience in health claims management.

3. Experience in people management required; able to attract and develop talent. Proven claims experience with multiple products including Medicare Supplement, major medical, hospital indemnity, life and disability insurance required.

4. Expert knowledge of medical terminology, ICD-9/ICD-10 codes, CPT/HCPCS and revenue codes required.

5. In-depth understanding of claims systems and electronic processing of medical claims (HIPAA ANSI 5010 electronic transactions) and imaging systems required.

6. Excellent organizational skills and attention to detail with the ability to manage multiple priorities and meet deadlines.

7. Ability to make sound judgments using strong critical thinking, analytical, research and problem-solving skills.

8. Demonstrated sense of discretion when handling confidential information.

9. Ability to effectively present information and respond to questions from staff, management, plan participants and business partners, using excellent verbal and written communications skills including creating and writing reports, business correspondence and procedure manuals.

This role is an exempt position, and the salary range for this position is $104,872 - $138,737. This is the lowest to highest salary we believe we would pay for this role at the time of this posting. An employee’s pay within the salary range will be determined by a variety of factors including but not limited to business consideration and geographical location, as well as candidate qualifications, such as skills, education, and experience. Employees are also eligible to participate in an incentive plan. To learn more about the American Medical Association’s benefits offerings, please click here.

We are an equal opportunity employer, committed to diversity in our workforce. All qualified applicants will receive consideration for employment. As an EOE/AA employer, the American Medical Association will not discriminate in its employment practices due to an applicant’s race, color, religion, sex, age, national origin, sexual orientation, gender identity and veteran or disability status.

THE AMA IS COMMITTED TO IMPROVING THE HEALTH OF THE NATION

Apply Now

Refine Your Search

senior claims adjuster jobs in downers grove il

Sr. Manager Claims (Remote)

Workers' Compensation Senior Claim Representative

Senior Property 1099 Field Adjuster (Illinois)

Senior Workers' Compensation Claims Specialist

Senior Workers Compensation Claims Adjuster - IL/IA

Senior Claims Specialist II

Senior Claims Manager

Senior Claims Specialist - Professional Liability - Non-Profit D&O

Senior Casualty Claims Specialist, Attorney Represented - Central Time Zone

Sr. Claim Representative/Claim Consultant

Senior Claims Examiner, Misc. Professional Liability

Sr Ability Analyst - Absence Management

Senior Manager, Construction Claims

Senior Claims Director-Commercial Direct Handle

Senior Claims Specialist

Casualty Claims Senior Specialist

Senior Technical Claim Manager-Miscellaneous Professional Liability/Errors & Omissions (E&O) (hybrid)

Senior Workers' Compensation Claims Examiner - Federal Claims

Senior Claims Specialist

Senior Property Adjuster - Chicago, IL

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