A critical component of the healthcare industry is the filing, processing, and managing of claims. An oftentimes behind the scenes and not as present function with considering a career in healthcare, claims department for either large healthcare or insurance organizations comprise hundreds of individuals working with providers and insurance to ensure claims to processed and filed correctly. The individuals responsible for overseeing this process is a Director of Claims.
With a Master of Science in Healthcare Administration from the University of Providence, business or healthcare professionals interested in pursuing the claims director position can learn the skills they need to excel within the position. Build on the core foundations of administrative healthcare practice, the Masters in Healthcare Administration program infuses core leadership components and applications into its curriculum, preparing graduates to not only the in-demand administrative skills but the qualities and components of strong, efficient leaders.
Learn more about the claim’s director position:
What is a Director of Claims
A Director of Claims is an administrative professional who is responsible for the daily operations of claims departments within a healthcare or insurance organization.
What does a Claims Director do?
A claims director is responsible for various tasks within the department. As a leader, they primarily focus on the facilitation of short, mid, and long-term goals within the department, as well as the management of department personnel and operations. Furthermore, the role includes working closely with other departments and ensuring timely/efficient filing of insurance claims.
Further responsibilities include:
- Establishing claims department guidelines, budgets and goals
- Communicating and collaborating with internal and external stakeholders
- Supervision of claims department personnel
- Remaining updated on the latest compliance and government regulation
- Assisting with complex claims or adjustments within the department
Where do Claim Directors Work?
Claim directors can be found working primarily for insurance companies – as they handle the majority of incoming and outbound claims. In some specific cases, they may focus on a particular type of claim, such as health insurance, housing, vehicle, or other specialization. However, in most cases, they will oversee all positions. Director of claims can also be found working in some larger healthcare organizations due to the number of claims funneling through the organization.
How to Become a Director of Claims
The path the becoming a claims director is lengthy given the seniority of the position, the scope of responsibility, and the level of education required. In many cases, the position requires a bachelor degree or higher for consideration, along with multiple years of experience working in claims or a relevant field. Since the director must be aware of all aspects of the department and its operations, the longer an individual works in the field the more experience they gain.
A common pathway includes:
- Graduate high school with a diploma or GED
- Earn a bachelors degree in business, healthcare administration, or relevant field
- Gain experience working in a claims department or relevant field
- [OPTIONAL]: Earn a graduate degree in business or healthcare administration
- [OPTIONAL]: Pursue specializations or certificates in relevant fields
Claims Director Career Path
The career path for claims directors sits near the top of career achievement. While those who hold the position can advance within the company, the position is at the senior level and reflects many of the benefits and downsides of a senior level position. In a report released by Zippia, the average salary for a them is $118,250 – almost double the average yearly salary in the U.S.
