ZipRecruiter

Log In

1

Direct Claims Jobs in Tennessee (NOW HIRING)

AMSURG

Director, Claims

Nashville, TN · On-site

Director, Claims Remote Company Overview: AMSURG is an independent leader in ambulatory surgery center services, operating a network of more than 250 surgery centers nationwide. In partnership with ...

Amsurg

Director, Claims

Nashville, TN · Remote

Director, Claims Remote Company Overview: AMSURG is an independent leader in ambulatory surgery center services, operating a network of more than 250 surgery centers nationwide. In partnership with ...

AmSurg LLC

Director, Claims

Nashville, TN · Remote

Director, Claims Remote Company Overview: AMSURG is an independent leader in ambulatory surgery center services, operating a network of more than 250 surgery centers nationwide. In partnership with ...

AmSurg LLC

Director, Claims

Nashville, TN · Remote

Director, Claims Remote Company Overview: AMSURG is an independent leader in ambulatory surgery center services, operating a network of more than 250 surgery centers nationwide. In partnership with ...

AMSURG

Director, Claims

Nashville, TN · Remote

Director, Claims Remote Company Overview: AMSURG is an independent leader in ambulatory surgery center services, operating a network of more than 250 surgery centers nationwide. In partnership with ...

Vertek Staffing

Claims Casualty Manager

Franklin, TN · Hybrid

$95K - $118K/yr

Roundtable large files with Director of Casualty Claims, Litigation Manager, and/or VP of Claims. Responsibility for the Average Paid metric for BI and UMBI claims closed and timely settlements ...

Wellpath

Claims Specialist

Franklin, TN

... direct clinical care, which includes lives saved by Narcan. We offer ongoing training and ... The Claims Specialist is responsible for the accurate and timely processing of medical claims in ...

Zenova

Claims Specialist

Franklin, TN

... direct clinical care, which includes lives saved by Narcan. We offer ongoing training and ... How you make a difference The Claims Specialist is responsible for the accurate and timely ...

next page

Showing results 1-20

All JobsDirect Claims JobsDirect Claims Jobs in Tennessee

Direct Claims information

What is a direct claim?

Direct claims refer to insurance claims that are filed directly by the policyholder with their own insurance company, rather than going through a third party or the at-fault party's insurer. This process is common in situations like auto accidents, where the policyholder seeks compensation for damages or losses under their own policy. Direct claims help streamline the process, reduce delays, and ensure the policyholder receives prompt assistance and settlements. They are often associated with 'first-party' insurance coverage, such as collision, comprehensive, or health insurance claims.

What are the key skills and qualifications needed to thrive as a direct claims specialist?

To thrive as a Direct Claims Specialist, you need a solid understanding of insurance policies, claims processes, and relevant legal regulations, often supported by a degree in business, finance, or a related field. Familiarity with claims management software, customer relationship management (CRM) systems, and sometimes industry certifications like AIC or CPCU is typical. Exceptional attention to detail, problem-solving abilities, and strong communication skills set top performers apart in this role. These skills and qualifications ensure claims are processed accurately and efficiently, leading to customer satisfaction and minimized risk for the insurer.

What are some common challenges faced by professionals in direct claims roles, and how can they effectively manage these challenges?

Professionals in Direct Claims often face the challenge of balancing a high volume of claims with the need for thorough investigation and timely resolution. Managing customer expectations and handling sensitive situations, such as denied claims or complex cases, can also be demanding. Effective communication, strong organizational skills, and staying updated on policy guidelines are crucial for success. Building collaborative relationships with adjusters, underwriters, and other departments helps ensure accurate and efficient claims processing.

What is the difference between Direct Claims vs Claims Adjuster?

AspectDirect ClaimsClaims Adjuster
CredentialsInsurance license, knowledge of policiesInsurance license, sometimes certifications like AIC or CPCU
Work EnvironmentCustomer service, office or remoteFieldwork, office, or remote
Employer & IndustryInsurance companies, agenciesInsurance companies, third-party administrators
Search & Comparison IntentUnderstanding direct claims handlingEvaluating claims adjustment roles

Direct Claims professionals primarily handle claims directly from policyholders, focusing on processing and resolving claims within the insurance company. Claims Adjusters evaluate, investigate, and settle claims, often working in the field or remotely. Both roles require insurance licensing, but Claims Adjusters may have additional certifications. While their work overlaps in claims processing, Direct Claims roles are more customer-facing, whereas Claims Adjusters focus on assessment and negotiation.

What are popular job titles related to Direct Claims jobs in Tennessee?

For Direct Claims jobs in Tennessee, the most frequently searched job titles are:

What job categories do people searching Direct Claims jobs in Tennessee look for?

The top searched job categories for Direct Claims jobs in Tennessee are:

What cities in Tennessee are hiring for Direct Claims jobs?

Cities in Tennessee with the most Direct Claims job openings:

Direct Claims jobs near you

Director, Claims

Nashville, TN • On-site

AMSURG
Health Care and Social Assistance • 10K+ employees

6.2

Company rating: 6.2 out of 10

Based on 24 frontline employees who took The Breakroom Quiz

People enjoy working here

Recommended by parents

Respectful managers

Learn more about AMSURGexternal

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 26 days ago

Job description

Director, Claims
Remote
Company Overview: AMSURG is an independent leader in ambulatory surgery center services, operating a network of more than 250 surgery centers nationwide. In partnership with physicians and health systems, the organization delivers high-quality care for patients across a diverse spectrum of medical specialties, including gastroenterology, ophthalmology and orthopedics. To learn more about AMSURG, visit www.amsurg.com.
POSITION SUMMARY:
Responsible for the investigation and handling of claims related to General Liability / Professional Liability, Employment Practices Liability, Cyber, and Property lines of coverage. Understands and communicates, as well as educates, claims management philosophy and strategy to Corporate and Center staff while building, maintaining, and managing relationships with claims adjusters and outside legal counsel. Designs, analyzes and delivers claim information to influence risk management behavior through performance metrics and benchmarking. Management of claims staff.
Work Schedule: Remote (Preferably Dallas, TX or Nashville, TN but candidates can reside anywhere in the United States).
ESSENTIAL RESPONSIBILITIES:
  • Oversight of the reporting of all claims to the insurance carriers and initiates the investigation of all Employment Practices Liability, Cyber, Property, General Liability, and Professional Liability claims. Assist in the investigation and reporting of Workers Compensation claims.
  • Handle claims within the Corporate or Center deductibles/retentions.
  • Responsible for the claims documentation in the RL6 Claims Management System as well as the in-house RMIS database, and produce reports from the systems.
  • Advises and assists Corporate and Center Staff in conducting investigations of incidents, including interviewing of witnesses and procurement of relevant documentation.
  • Establish relationships with defense attorneys and assist in discovery and investigation.
  • Provides training on claims reporting to Corporate and Center staff and helps communicate Workers Compensation benefits and the importance of the Return-to-Work policy.
  • Prepares reports and analyses for the VP of Insurance/Corporate Risk Management summarizing the loss data provided by insurance companies, highlighting adverse trends and their financial impact, and making recommendations on how to minimize/avoid the risks.
  • Conducts claims meetings with insurance carriers on a quarterly basis to evaluate open reserves.
  • Obtains and tracks centers' historical claims data needed for the actuarial study.

QUALIFICATIONS:
To perform this job successfully, an individual must be able to perform each essential responsibility satisfactorily. The requirements listed below are representative of the knowledge, skills and/or abilities required.
Education/Experience:
  • Bachelor degree from an accredit college or university with a minimum of six (6) years' experience as a claims handler required. Professional Liability and Workers Compensation experience highly preferred.

Mathematical Skills:
  • Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions, decimals and percentages.

Technical Skills:
  • Expert in Microsoft Excel and experience with financial reporting systems is required. Ability to work with web-based claims management system and prepare reports also required.

Language Skills:
  • Ability to understand, read, write and speak English. Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures or governmental regulations. Ability to successfully write business correspondence. Ability to effectively present information, respond to questions and professionally interact with managers, employees, clients, vendors and the general public.

Reasoning Ability:
  • Ability to recognize and define problems, collect data, establish facts, draw valid conclusions and correct errors. Ability to understand and interpret basic financial data. Ability to interpret a variety of instructions in a variety of forms and deal with abstract and concrete variables.

Other Qualifications:
  • Must be able to handle multiple, simultaneous tasks effectively and efficiently while maintaining a professional, courteous manner. Must be able to work well with others. Strong verbal and written communication skills required. Must be detail oriented and organized. High integrity, including maintenance of confidential information. Must be able to exercise good judgment and positively influence and lead others, including handling confrontations with poise and efficiency. Based on business need, the ability to work a flexible schedule, including some evenings and weekends as approved in advance.

Employment at AMSURG: Living Our Values Every Day
At AMSURG, our values define who we are and how we serve our patients, partners, and each other. As a national leader in ambulatory surgery, we are committed to a culture of excellence, integrity, teamwork and caring deeply. Our values guide every decision, ensuring we continue to elevate healthcare and provide the highest quality care.
These guiding principles are the foundation of our culture and a guide to how we collaborate, innovate, and make a difference every day.
  • Care Deeply for those around us.
  • Cultivate Integrity to build trust.
  • Champion Excellence for continuous improvement
  • Celebrate Teamwork every step to the way.

Benefits:
To ensure we retain and invest in great people, AMSURG provides its employees with the benefits, recognition, training, and opportunities needed for professional growth. Our wide range of health and welfare benefits allow you to choose the right coverage for you and your family. AMSURG offers a variety of health and welfare benefit options to help protect your health and promote your wellbeing. Benefits offered include but are not limited to: Paid Time Off, Medical, Dental, Vision, Life, Disability, Healthcare FSA, Dependent Care FSA, Limited Healthcare FSA, FSAs for Transportation and Parking & HSAs, and a matching 401(K) Plan.
Paid Time Off:
AMSURG offers paid time off, 9 observed holidays, and paid family leave. You accrue Paid Time Off (PTO) each pay period and depending on your position and can earn a minimum of 20 days and up to 25 days per calendar year.
EOE Statement:
AMSURG is an Equal Opportunity Employer (EOE). Qualified applicants are considered for employment without regard to age (40 or older), race, color, religion, gender, sex, national origin, pregnancy, sexual orientation, disability, genetic information or any other status protected under applicable federal, state, or local laws. We strive to also provide a disability inclusive application and interview process. If you are a candidate with a disability and require reasonable accommodation in order to submit an application, please contact us at: careers@amsurg.com. Please include your full name, the role you're applying for and the accommodation necessary to assist you with the recruiting process.
#LI-CH1
#LI-REMOTE
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

What AmSurg employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply