Claim Financial Process Manager

Overview Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: + Comprehensive health benefits that start day 1 + Student Loan Repayment Assistance & Reimbursement Programs + Family-focused benefits + Wellness incentives + Ongoing mentorship, _development,_ and leadership programs + And more Work Location: Atlanta, GA Description + Plays a key role in protecting the financial stability of Emory University, Emory Healthcare, and its wholly owned insurance subsidiary, Clifton Casualty Insurance Co. Ltd. (CCIC) + Processes and monitors claim related payments and assures monthly reconciliation for EHC, CCIC, and its actuary + Manages the monthly indemnity and legal expense payment process for Medical Professional, General Liability and Network Security & Privacy matters payable under the Emory Liability Insurance Program through CCIC + Tracks and creates monthly loss runs which tracks all payment and reserve related movement for third party liability matters insured under CCIC + This role also has claims data analytics components, responsibility for analyzing insurance claims data for reporting purposes, to find trends, and support decisions + The Claim Financial Process Manager will collect data, perform statistical analysis, create dashboards/ reports and collaborate with teams including Claims, Risk, Patient Safety, Quality, and Clinical operating units + The goal is to bring awareness to claims holistically to help inform risk, patient safety and quality initiatives, ultimately to improve patient outcomes and reduce claims and claim costs + Management of Financial processes for CCIC: + Manages time-sensitive monthly financial data processes, including inputting initial reserves and reserve changes, case settlements, legal and related vendor invoices, monthly accounting reconciliation and balancing, and fiscal year end closing + Responsible for running and balancing the monthly loss runs for CCIC + Data Analysis & Reporting: + Collect, validate, normalize, and analyze medical professional and general liability claim data + Develop, maintain, and run standard and ad hoc reports, including but not limited to monthly loss runs, transaction reports, and trend and severity analyses + Update tower erosion and exhaustion reports to track aggregate losses, paid/incurred amounts, and remaining limits across coverage layers + Work with actuarial team to support actuarial analyses by preparing clean, accurate datasets for loss projections, reserve studies, and pricing evaluations + Translate complex insurance and claims data into clear, actionable insights for leadership, risk management, legal, and finance stakeholders + Respond to requests for specific data reports, such as claims data Medicaid and Medicare applications + Develop dashboards and visual reports to track loss performance, emerging risks, and program effectiveness + Identify opportunities to improve reporting efficiency, automation, and data accessibility + Use data to support strategic risk mitigation initiatives and loss prevention efforts + Assist in developing key performance indicators (KPIs) and metrics for captive operations + Support internal and external audits by providing accurate, timely, and well-documented data + Support system upgrades, data migrations, and enhancements related to reporting and analytics; for the claims management system, currently RLDatix + Reinsurance & External Carrier Reporting: + Work with VP, Insurance, captive manager, and insurance broker to track reinsured losses, recoverables, ceded premiums, and reinsurer participation by layer + Support reconciliation of reinsurance payments and recoverables with finance and accounting teams + Respond to reinsurer data requests, audits, and ad hoc reporting needs + Regulatory & Statutory Reporting: + Manage and support MMSEA (Medicare Secondary Payer) Section 111 reporting, including: + a. Data extraction and validation + b. Timely and accurate submissions to CMS + c. Resolution of CMS errors, rejects, and compliance issues + Support National Practitioner Data Bank (NPDB) reporting by ensuring data accuracy, completeness, and compliance with reporting thresholds and timelines + Additional Duties as Assigned + Travel: Less than 10% of the time may be required + Work Type: Hybrid employee - splits time between working remotely and working in the office MINIMUM REQUIRED QUALIFICATIONS: + Education: Bachelor's degree in a business-related field + Experience: Minimum five years relevant experience Knowledge, Skills & Abilities + Knowledge of legal and insurance claims handling principles + Basic accounting skills, ability to navigate various data systems and strong data skills + Proficiency with data analysis tools, SQL, BI software (e.g., Tableau, Power BI), and statistical techniques + Presentation skills JOIN OUR TEAM TODAY Emory Healthcare (EHC), part of Emory University (EUV), is the most comprehensive academic health system in Georgia and the first and only in Georgia with a Magnetu00ae designated ambulatory practice. We are made up of 11 hospitals-4 Magnetu00ae designated, the Emory Clinic, and more than 425 provider locations. The Emory Healthcare Network, established in 2011, is the largest clinically integrated network in Georgia, with more than 3,450 physicians concentrating in 70 different subspecialties. Additional Details Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law. Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. To request this document in an alternate format or to request a reasonable accommodation, please contact Emory Healthcareu2019s Human Resources at . Please note that one week's advance notice is preferred. Connect With Us Connect with us for general consideration Division _Emory Healthcare Inc._ Campus Location _Atlanta, GA, 30345_ Campus Location _US-GA-Atlanta_ Department _EHI Office of Insurance Srvc_ Job Type _Regular Full-Time_ Job Number _160162_ Job Category _Business Operations_ Schedule _8a-4:30p_ Standard Hours _40 Hours_ Hourly Minimum _USD $48.93/Hr._ Hourly Midpoint _USD $59.62/Hr._Emory Healthcare is an Equal Employment Opportunity employer committed to providing equal opportunity in all of its employment practices and decisions. Emory Healthcare prohibits discrimination, harassment, and retaliation in employment based on race, color, religion, national origin, sex, sexual orientation, gender identity or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services, veteran status or any other classification protected by applicable federal, state, or local law.

Created: 2026-01-30