An employer in the Dayton, OH area is seeking a Director of Claims Operations for a year long contract opportunity. The current Director will be taking over the claim operation of a company recently acquired by the client so will need to assume that role until said company is integrated 7/2026. This person will be responsible for overseeing the activities of the Claims department to ensure appropriateness of all aspects of claims adjustment and adjudication processes. They also will be directing and coordinating the activities of claims and data entry areas including direct supervision of 3 managers, 35-40 claims personnel, and working with their third-party claims processing partner. Their main goals will be to increase the company's overall speed to payment, decrease inventory of claims, as well as working towards auto-adjudication with IT. The company uses TriZetto Facets as their claims processing platform and this person will be taking part in projects related to their system.
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Associates degree in business or related field or equivalent relevant work experience is required
Bachelors degree is preferred
Minimum of five (5) years of healthcare claims experience is required
Minimum of five (5) years of leadership experience is required
Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.