Hiring.Camp

Director, Claims (Commercial-Self-Funded)

The Health Plan

·

Jun 15, 2026

Location
Wheeling, WV
Workplace
Onsite
Type
Full-time
Department
Management
Seniority
Director
Experience
5+ years
Education
Bachelor
Industry
Healthcare
Category
Healthcare
Environment
Office
Source
ADP

Overview

As Director of Claims, you'll manage all aspects of institutional and professional claims review for medical appropriateness and compliance. You'll lead teams responsible for claims processing, develop and implement claims review procedures, and ensure prompt payment regulations are met. The role requires a Bachelor's degree or equivalent experience, 5+ years of claims leadership experience, and expertise in medical claims payment, ICD-10, NDC, and HCPCS. You'll be responsible for staff management, productivity monitoring, and strategic planning. Strong analytical skills and experience with Excel are essential.

Skills

Microsoft Excel

Languages

English