Consultant, Claims Processing Oversight Job at Kirby Bates Associates

Project Supervisor

This role will serve as a Project Supervisor (Intake) assigned to the Radiation ...

Location

United States , Washington

Salary:

65000.00 USD / Year

Amentum

Expiration Date

Until further notice

Requirements

At least two years of progressively more responsible experience on major litigation support projects, including at least one year of supervisory experience
Requires in-depth knowledge of litigation support, excellent written and oral communication skills
Must be able to anticipate litigation support and claims intake needs, and develop and execute detailed plans for addressing those needs
Experience in claim management or processing environments, particularly having worked with a claim management system
Familiarity with document scanning, intake protocols, and document management technology – to included quality control and verification standards
Experience in creating, updating, and training on claims intake and processing procedures
Highly skilled in coordinating across teams and with other Managers, Supervisors, team members, and clients
Demonstrated ability to oversee and coordinate numerous complex and time-critical claim support activities simultaneously, including technical/data processing support activities
Requires hands-on familiarity with the Government's office and network environment, including but not limited to, data processing environments, including office automation networks, PC-based databases and other applications, and internet and server-based databases and other applications
Undergraduate degree required

Job Responsibility

Act as primary supervisor for assigned staff members, to include oversight of timekeeping, narratives, corrective action, and other staff management concerns
Assist Project Manager in all aspects of Claims Intake team management
Assist in the daily oversight and management of Claims Intake support processes
Coordinate tasks and responsibilities of the team members on the Claim Intake Team
Identify daily team priorities and communicate expectations of priorities to team members. This involves monitoring various claim statuses or queues
Determine individual team member capacity and reassign members to high priority tasks, while maintaining coverage of other team tasks
Create and prepare routine Intake metrics report in consultation with Federal Attorney Team Leads and Project Manager – to identify data points essential for tracking and performance forecasts
Assign work to team in consultation with Federal Attorney Team Leads and Project Manager, and track and monitor progress, ensure work is completed and check for quality and accuracy
Thorough knowledge of tasks, task objectives, and the context of those tasks in the claim review lifecycle
Organize and maintain special project assignments

What we offer

medical dental and vision insurance
401(k) retirement plan
life insurance
long-term and short-term disability insurance
15 days of paid time off
parental leave
health, dental, and vision insurance
paid time off and holidays
retirement benefits (including 401(k) matching)
educational reimbursement

Fulltime

Senior Innovation Analyst

GEICO is hiring a Senior Innovation Analyst to join their Claims Innovation team...

Location

United States , Chevy Chase; Katy; Macon; Richardson; Lakeland

Salary:

91225.00 - 172200.00 USD / Year

Geico

Expiration Date

Until further notice

Requirements

8+ years experience in business process optimization, business analysis, consulting, innovation, and/or process engineering/optimization
Bachelor’s degree in Business, Finance, Economics, Statistics or other related area
Management experience in P&C insurance claims, with subject matter expertise in material damage, casualty, or commercial auto claims handling preferred
Experience in the Insurance and/or InsurTech industry(ies), preferably within claims
Experience in innovation or transformation roles, preferably within P&C insurance
Experience evaluating technology opportunities/solutions and developing technology product strategy, plans, and roadmaps.
Demonstrated competence in innovation methodologies, processes, and principles
Effective communicator with the ability to clearly articulate a common strategic vision
Experience working in collaboration with multiple stakeholders
Ability to identify and execute on opportunities exposed by evolving process & technology

Job Responsibility

Evaluate the current state of the business process and associated technology, identify areas of opportunity for improvement, and develop actionable strategies based on findings
Lead the overall management of process performance by developing control limits, monitoring key performance indicators, and informing stakeholders of any deficiencies, improvements, operational risks issues, etc. and drive collaborative efforts to ensure process delivers against requirements.
Apply and maintain expert knowledge of the business and manage ongoing alignment and development of business deliverable processes and capabilities with business needs to materially change and improve business performance
Utilize data and analytics to deliver insight into customer and business process performance and shares best practices with overall team.
Evaluating and analyzing existing claims workflows, data, and key metrics to identify areas of opportunity for efficiency, effectiveness, or accuracy
Guide and influence process re-engineering and technology implementation to enable innovative workflow redesign
Preparing, summarizing, and delivering reports and/or presentations on findings or project progress
Collaborating with Operations and Product teams to gather, define, and prioritize requirements, features, and specifications
Identifying, tracking, and monitoring project risks and expected benefits
Assisting the Director, Claims Innovation in establishing priorities, goals, and objectives

What we offer

Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family’s overall well-being.
Financial benefits including market-competitive compensation
a 401K savings plan vested from day one that offers a 6% match
performance and recognition-based incentives
and tuition assistance.
Access to additional benefits like mental healthcare as well as fertility and adoption assistance.
Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year.

Fulltime

Consultant, Claims - Indemnity Specialty

Our team handles some of the most unique and interesting insurance claims at Nat...

Location

United States

Salary:

97000.00 - 180000.00 USD / Year

Nationwide

Expiration Date

Until further notice

Requirements

Demonstrated experience handling toxic tort with emphasis on asbestos and/or silica bodily injury claims, including evaluation, negotiation, and resolution
Proven ability to manage toxic tort bodily injury litigated files, including collaboration with defense counsel, strategy development, and oversight of litigation budgets and outcomes
Undergraduate degree in related field preferred
Post-graduate studies preferred
State licensing where required
Relevant professional designations or certifications desirable (CPCU, CLU, IIA, AEI, etc.)
Eight years of specialty claims experience preferred
Proven superior knowledge of the best claims practices used to resolve the most sever and technically complex claims
Demonstrated knowledge of insurance contracts and legal aspects affecting regulatory and liability issues that relate to environmental and other specialty claims
Proven ability to meet customer needs and provide outstanding service by informing customers of the claims process and ensuring a positive customer experience

Job Responsibility

Completes detailed review and analysis of claims
Investigates liability and damages
Brings files to closure, either by voluntary dismissals or by negotiation of settlements
Resolves amount of appropriate settlements or grounds for denial
Assists in the drafting of settlement documents
Provides reserve analysis to ensure timely and accurate case reserves in according to optimal claims practices
Negotiates cost sharing agreements between other insurance carriers and policyholders
Maintains current knowledge of assigned insurance lines, court decisions which may impact the claims function, current guidelines and policy changes and modifications
Creates and analyzes severe incident reports, reinsurance reports and other information to corporate office, Claims Management and Underwriting
Performs continuous review of claims inventory

What we offer

medical/dental/vision
life insurance
short and long term disability coverage
paid time off with newly hired associates receiving a minimum of 18 days paid time off each full calendar year pro-rated quarterly based on hire date
nine paid holidays
8 hours of Lifetime paid time off
8 hours of Unity Day paid time off
401(k) with company match
company-paid pension plan
business casual attire

Fulltime

Claims Fraud Consultant

Are you looking for a new challenge? Fancy helping us shape the future of motor ...

Location

United Kingdom , Manchester

Salary:

Not provided

Prima

Expiration Date

Until further notice

Requirements

Proven experience in managing Claims Fraud
Aware of current market strategies
High level of technical competency, which can be demonstrated in case handling and through case discussion
High level of knowledge of market-leading Fraud tools such as SIRA
Ability to utilise data to interpret performance trends and translate insights into actionable commercial strategies
Highly effective communicator and influencer with strong influencing skills, capable of building credibility and managing relationships with both internal senior leaders and external partners

Job Responsibility

TPA Oversight & Relationship Management: Supervise and manage the Third Party Administrator, conduct case reviews and audits, identify leakage or process gaps, and maintain a strong, constructive working relationship
Technical Expertise & Complex Claims Support: Provide fraud expertise, supporting the UK Claims Manager with large or complex cases and presentations to reinsurers and internal stakeholders
Fraud Claims Handling & Team Development: Initially manage fraud claims directly, later supporting leadership as the team grows, and contribute to the design and delivery of technical training to strengthen fraud capability
Platform & System Development: Contribute to the development of the Global Claims Platform, shaping efficient processes and driving its evolution to become market-leading
Strategy, Governance & Compliance: Support the long-term fraud strategy, establish robust governance and performance frameworks, and ensure adherence to protocols and case strategies
Process Improvement & Escalation Management: Lead change initiatives to improve efficiency, digital adoption, and customer experience, while acting as the final escalation point for complex or high-value fraud cases

What we offer

Hybrid working, with a mix of home and office days
Access to learning resources, mentorship and a growth plan tailored to you
Private healthcare, gym discounts, wellbeing programs and mental health support

Fulltime

Contracts Administrator

We are seeking a Contracts Administrator for a $100m+ building upgrade and refur...

Location

Australia

Salary:

Not provided

Hickory

Expiration Date

Until further notice

Requirements

Minimum of 5 years of experience as a Contracts Administrator delivering commercial fit out, refurbishment and building upgrade projects
Demonstrated experience administering head contracts and subcontracts across fast paced fit out and refurbishment works, with strong commercial oversight of cost, programme and risk
Proven ability to manage procurement processes, negotiate subcontract packages, assess variations and progress claims, and maintain accurate financial forecasting and reporting
Strong capability in building and maintaining relationships with clients, consultants, subcontractors and key stakeholders, particularly within live and occupied environments
Solid understanding of contract administration, compliance, risk management and project governance specific to fit out and refurbishment projects
Hands on experience supporting projects within operational buildings, including staged works, shutdowns and works within constrained or high traffic sites

Job Responsibility

Collaborate with Project Managers on financial activities
Review Bill of Quantities including agreed Value Management Items and set up project budgets, ensuring accuracy and seeking clarity where alignment with estimates is not achieved
Implement and maintain financial tools
Process financial tasks according to Hickory’s Financial calendar
Provide accurate, timely financial reports
Maintain project financial records
Submit progress claims promptly
Monitor and expedite payments
Administer site payments and supplies
Process payments in financial software (e.g., Cheops)

What we offer

Work-Life Balance: Enjoy a balanced work-life schedule with a standard 5-day work week
Family-Friendly Policies: Receive paid parental leave to support your family needs
Novated Leases: Take advantage of novated leasing options to maximize your salary and enjoy tax savings on vehicle expenses
H-Perks Employee Rewards: Access exclusive discounts, cashback and everyday savings through our internal benefits platform
Employee Wellbeing: Access our Employee Assistance Program (EAP) for valuable support and resources
Diverse Opportunities: Gain exposure to a wide range of roles and industry leaders in our leading market company

Pharmacist I

We are seeking a licensed Pharmacist to support a high-performing ambulatory pha...

Location

United States , Sandusky; Lorain

Salary:

60.00 USD / Hour

MMC Group LP

Expiration Date

Until further notice

Requirements

Bachelor of Science in Pharmacy or PharmD from an accredited institution
Active, unrestricted Ohio Pharmacist License (required)
1-3 years of retail or ambulatory pharmacy experience
Strong understanding of pharmaceutical products, drug interactions, and patient care practices

Job Responsibility

Evaluate, prepare, and dispense medications in accordance with professional standards and regulatory requirements
Provide direct patient consultation regarding medication therapy, usage, and potential interactions
Review patient care plans to ensure therapeutic appropriateness and optimize outcomes
Collaborate with prescribers and healthcare staff to develop effective treatment plans
Ensure compliance with all federal, state, and organizational pharmacy regulations
Maintain oversight of controlled substance security, record keeping, and quality assurance protocols
Monitor and update patient profiles for insurance verification and regulatory compliance
Process and review prescription claims, ensuring accurate reimbursement and resolving discrepancies
Support oversight of pharmacy technicians, including scheduling, training, and performance management
Monitor team performance to ensure adherence to operational and clinical standards

What we offer

Medical, dental, and vision coverage
Life and disability insurance
Additional voluntary benefits

Parttime

Medical Director

Direct, lead and provide professional oversight for medical management activitie...

Location

United States , Phoenix

Salary:

Not provided

Blue Cross Blue Shield of Arizona

Expiration Date

Until further notice

Requirements

3 years of experience in a clinical setting
1 year of experience in physician leadership role, including quality review, utilization review and other managed care functions
Medical Degree
Active, current, and unrestricted license to practice medicine in the State of Arizona (a state in the United States)
Board Certification

Job Responsibility

Direct, lead and provide professional oversight for medical management activities related to utilization management, case management, disease management, and quality management activities
Provide direction, support and medical expertise and oversight to areas within the Health Services Division such including utilization management, quality management, case management, medical claims review, and pharmacy management
Provide consultative services throughout the corporation
Communicate with customers regarding their difficult and costly cases
Seek to improve department/division efficiency through effective use of information system tools
Review, and implement medical policies and other medical decision-making policies or procedures
Represent BCBSAZ at professional organizations and acts as liaison with individual health care professionals
Provide professional oversight for the various clinical peer committees
Participate in the appeals and grievance processes
Provide written information to members and providers

Fulltime

Financial Aid Analyst/Specialist

We are looking for a dedicated Financial Aid Analyst/Specialist to join our team...

Location

United States , Bridgewater

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Associate's degree or higher in a relevant field
Proficiency in Microsoft Office applications, including Word, Excel, and Outlook
Prior experience with electronic healthcare record systems is preferred
Strong communication and interpersonal skills to interact effectively with patients and team members
Ability to manage accounts and payments with precision and attention to detail
Familiarity with financial aid processes and administrative oversight
Competency in handling incoming payments and account setup
Expertise in utilizing 10-key skills for efficient data entry and calculations

Job Responsibility

Conduct consultations with patients to explain financial obligations, address inquiries about financial policies, and establish clear payment expectations
Record and update patient insurance details in electronic systems to maintain accurate documentation
Provide cost estimates for upcoming treatments and ensure patients are informed of their financial responsibilities
Collect payments from patients, allocate funds appropriately, and manage accounts throughout the treatment process
Reconcile weekly reports to verify that patient financial obligations have been accurately met
Evaluate patient accounts to identify and resolve outstanding balances efficiently and logically
Collaborate with finance teams to address claims, insurance issues, and correspondence for successful account resolution
Respond to patient inquiries regarding billing concerns, financial policies, and claims submissions with attention to detail
Perform other related tasks as assigned to support the financial coordination process

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

Consultant, Claims Processing Oversight

Kirby Bates Associates

Location:
United States

Category:
Consulting

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
May 16, 2026

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Our AI answers in your language

Consultant, Claims Processing Oversight

Kirby Bates Associates

Location:United States

Category:Consulting

Contract Type:Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:May 16, 2026

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Job Posted:
May 16, 2026