Job DescriptionJob SummaryAcrisure is seeking a Claims Director to join our growing SBMA team. SBMA, a third-party administrator, is an affordable ACA-compliant benefits provider to thousands of employers. Their goal is to simplify the complexity of providing employee benefits. SBMA is different because of its personal service, speed of implementation, and innovative approach to benefits coverage.
We are seeking an experienced and results-driven Claims Director to lead and oversee our claims operations within a Third-Party Administrator (TPA) environment. This role is responsible for ensuring efficient, compliant, and high-quality claims processing while driving continuous improvement and exceptional client service.
Responsibilities - Lead and manage the claims department, including supervisors, claims analysts, and support staff, fostering a culture of accountability, performance, and professional development.
- Develop, implement, and continuously refine claims strategies, policies, procedures, and best practices aligned with organizational and client objectives.
- Ensure timely, accurate, and fair claims processing in full compliance with applicable federal, state, and contractual regulations.
- Monitor, analyze, and report on claims performance metrics, identifying trends, risks, and improvement opportunities.
- Ensure adherence to compliance standards, internal controls, and audit requirements, including preparation for and response to internal and external audits.
- Handle escalated customer and client issues with professionalism, sound judgment, and a resolution-focused approach.
- Collaborate with executive leadership, clients, and operational partners to support business growth and client satisfaction.
- Drive operational efficiency, quality improvements, and staff engagement across the department.
Requirements - Expert-level proficiency in HealthPac.
- Strong knowledge of claims compliance, regulatory requirements, and audit standards.
- Advanced Excel and reporting skills.
- Exceptional attention to detail and organizational abilities.
- Excellent communication, problem-solving, and analytical skills.
- Ability to handle sensitive information with confidentiality.
Education and Experience - Bachelor's degree in business, Healthcare Administration, Insurance, or a related field.
- 7+ years of progressive claims management experience, including leadership within a TPA, insurance carrier, or self-insured environment.
- Proven ability to lead teams, manage performance metrics, and resolve complex claims or client issues.
- Experience with claims systems, reporting tools, and performance dashboards.
Pay Details:
The base compensation range for this position is $100,000 - $135,000. This range reflects Acrisure's good faith estimate at the time of this posting. Placement within the range will be based on a variety of factors, including but not limited to skills, experience, qualifications, location, and internal equity.
Candidates should be comfortable with an on-site presence to support collaboration, team leadership, and cross-functional partnership.Why Join Us:At Acrisure, we're building more than a business, we're building a community where people can grow, thrive, and make an impact. Our benefits are designed to support every dimension of your life, from your health and finances to your family and future.
Making a lasting impact on the communities it serves, Acrisure has pledged more than $22 million through its partnerships with Corewell Health Helen DeVos Children's Hospital in Grand Rapids, Michigan, UPMC Children's Hospital in Pittsburgh, Pennsylvania and Blythedale Children's Hospital in Valhalla, New York.
Employee BenefitsWe also offer our employees a comprehensive suite of benefits and perks, including:
- Physical Wellness: Comprehensive medical insurance, dental insurance, and vision insurance; life and disability insurance; fertility benefits; wellness resources; and paid sick time.
- Mental Wellness: Generous paid time off and holidays; Employee Assistance Program (EAP); and a complimentary Calm app subscription.
- Financial Wellness: Immediate vesting in a 401(k) plan; Health Savings Account (HSA) and Flexible Spending Account (FSA) options; commuter benefits; and employee discount programs.
- Family Care: Paid maternity leave and paid paternity leave (including for adoptive parents); legal plan options; and pet insurance coverage.
- ... and so much more!
This list is not exhaustive of all available benefits. Eligibility and waiting periods may apply to certain offerings. Benefits may vary based on subsidiary entity and geographic location.
