Director, Health Claims Administration
Apply NowCompany: System One Holdings, LLC
Location: Newtown Square, PA 19073
Description:
Job Title: Director, Health Claims Administration
Location: Newtown Square, PA
Salary Range: $175,000 - $195,000 + Bonus BOE
Schedule: Hybrid
Overview
We are seeking an experienced and strategic Director of Health Claims Administration to lead and oversee all operational aspects of our Claims Department. This senior-level position plays a key role in ensuring the accurate, timely, and compliant adjudication of medical, dental, vision, and weekly income claims. As a key liaison to the Board of Trustees and a leader within the organization, this individual must bring deep expertise in health claims management, compliance, and team leadership. Travel is anticipated at 10-20% of the year in this a hybrid position based in Newtown Square, PA, offering a dynamic leadership opportunity within a mission-driven, high-impact environment. Apply today for immediate consideration!
Responsibilities
Requirements
Location: Newtown Square, PA
Salary Range: $175,000 - $195,000 + Bonus BOE
Schedule: Hybrid
Overview
We are seeking an experienced and strategic Director of Health Claims Administration to lead and oversee all operational aspects of our Claims Department. This senior-level position plays a key role in ensuring the accurate, timely, and compliant adjudication of medical, dental, vision, and weekly income claims. As a key liaison to the Board of Trustees and a leader within the organization, this individual must bring deep expertise in health claims management, compliance, and team leadership. Travel is anticipated at 10-20% of the year in this a hybrid position based in Newtown Square, PA, offering a dynamic leadership opportunity within a mission-driven, high-impact environment. Apply today for immediate consideration!
Responsibilities
- Deep understanding of healthcare regulations, claims adjudication, and compliance (HIPAA, PHI, etc.).
- Proven success in directing teams, managing complex operations, and communicating effectively with senior stakeholders.
- Strong judgment, attention to detail, and ability to thrive in a fast-paced, self-directed environment.
Requirements
- Bachelor's degree in Healthcare Administration, Business Administration, or related field (Master's preferred).
- Extensive experience with healthcare claims processing, policy development, and vendor oversight.
- Demonstrated success leading claims adjudication functions.
- Exceptional leadership, communication, and interpersonal skills.
- Strong writing and presentation capabilities, including delivering reports and recommendations to the Board of Trustees.
- Proficiency in medical and health plan terminology and systems.
The company provides competitive total reward offerings that consist of compensation, benefits, recognition, along with a wealth of other well-being, work-life and recognition programs which support in unlocking the potential for you and your family. Included in our expansive list of benefits offerings are multiple group medical, dental and vision plans, a robust wellness program, life insurance and disability coverages, also a variety of voluntary programs such as group accident, hospital indemnity, critical illness, pet insurance and much more. To help you save for retirement, we offer a 401(k) plan with a matching contribution and for work-life balance we have vacation and sick time programs for associates. For us, it's about protecting the personal welfare of our associates and their families, helping to achieve personal goals and offering those extra touches for convenience, security and overall peace of mind.
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