Overview
Insurance Claims Manager Jobs in Remote at Placemint Agency
Job Overview
We are seeking a dynamic and detail-oriented Insurance Claims Manager to lead our claims processing operations across various insurance lines. In this pivotal role, you will oversee the entire claims lifecycle, ensuring efficient handling, accurate assessment, and fair resolution of claims related to auto, workers’ compensation, water damage restoration, mold remediation, and other property and casualty areas. Your expertise will drive risk management strategies, fraud prevention initiatives, and service excellence, all while maintaining compliance with industry standards. Join us to empower our team with your leadership and technical skills in a fast-paced environment committed to integrity and customer satisfaction.
Responsibilities
- Manage the end-to-end claims process for diverse insurance lines, workers’ compensation, water damage restoration, and medical claims.
- Lead investigations into complex claims by applying analysis skills, medical terminology knowledge, ICD coding (ICD-9/ICD-10), CPT coding, and HCPCS standards to determine coverage and liability.
- Collaborate with underwriters to evaluate risk factors through risk analysis and underwriting principles to facilitate fair claim settlements.
- Implement fraud prevention and detection techniques by scrutinizing medical records, medical documentation, and insurance verification processes.
- Coordinate with auto estimating teams, auto body repair shops, construction inspectors, mold remediation specialists, and automotive service providers to assess damages accurately.
- Utilize financial software and insurance management systems to document claims activities meticulously and generate detailed reports.
- Develop strategies for risk management by analyzing trends in water damage restoration, mold remediation, auto restoration, and other property claims to minimize future exposures.
- Negotiate claim settlements effectively while ensuring compliance with company policies and industry regulations.
- Maintain organizational efficiency through clerical experience such as data entry, file management, and correspondence related to medical billing or insurance documentation.
Skills
- Strong negotiation capabilities with a focus on achieving equitable outcomes for clients and the company.
- Extensive knowledge of underwriting principles combined with expertise in auto estimating and automotive repair processes.
- Proficiency in fraud prevention techniques along with a solid understanding of risk analysis methodologies.
- Familiarity with medical terminology, ICD coding (ICD-9/ICD-10), CPT coding, HCPCS standards, and medical billing procedures.
- Experience in water damage restoration practices, mold remediation procedures, construction inspection protocols, and auto service management.
- Ability to interpret complex medical records and medical documentation accurately for claims evaluation.
- Organizational skills that enable efficient management of multiple claims files simultaneously while maintaining attention to detail.
- Knowledge of financial software applications used within insurance claim processing environments.
Join us as an Insurance Claims Manager if you are passionate about delivering exceptional service while leveraging your technical expertise in a collaborative environment dedicated to integrity and excellence!
Pay: Up to $110,000.00 per year
Benefits:
- 401(k)
- Health insurance
Work Location: Remote
Title: Insurance Claims Manager
Company: Placemint Agency
Location: Remote
