Casualty Manager
Guaynabo, PR · On-site
JOB SUMMARY In charge of leading our casualty claims management efforts, overseeing all aspects of claims handling, from investigation to resolution. Is responsible for managing high-risk claims ...
Casualty Manager
Guaynabo, PR · On-site
JOB SUMMARY In charge of leading our casualty claims management efforts, overseeing all aspects of claims handling, from investigation to resolution. Is responsible for managing high-risk claims ...
Managed care experience * Claims processing experience * Medical record familiarity * Experience in healthcare claims investigations * Experience in lean and/or six sigma methodology At UnitedHealth ...
Managed care experience * Claims processing experience * Medical record familiarity * Experience in healthcare claims investigations * Experience in lean and/or six sigma methodology At UnitedHealth ...
Support alignment between onshore expectations and offshore execution without direct people management. * Data Analysis, Insights & Forecasting * Analyze claims data to identify trends in frequency ...
Support alignment between onshore expectations and offshore execution without direct people management. * Data Analysis, Insights & Forecasting * Analyze claims data to identify trends in frequency ...
Conducts data entry and claims processing/issues * Handling issues within turnaround standards * Ability to handle most claim types / cases / issues that are submitted to the team you are supporting
New
Conducts data entry and claims processing/issues * Handling issues within turnaround standards * Ability to handle most claim types / cases / issues that are submitted to the team you are supporting
New
Rebill corrected claims and route issues to coding, billing, credentialing, denials, and/or ... Ability to manage and prioritize multiple tasks in a fast-paced and dynamic environment * Strong ...
Rebill corrected claims and route issues to coding, billing, credentialing, denials, and/or ... Ability to manage and prioritize multiple tasks in a fast-paced and dynamic environment * Strong ...
Claims Examiner
Guaynabo, PR · On-site
$21/hr
Managed Care or Medicaid coding experience.Associate degree in Health Information Management, Medical Coding, Healthcare Administration, or a related field (or equivalent experience). Excellent ...
Claims Examiner
Guaynabo, PR · On-site
$21/hr
Managed Care or Medicaid coding experience.Associate degree in Health Information Management, Medical Coding, Healthcare Administration, or a related field (or equivalent experience). Excellent ...
Lead project change control, contractor performance reviews, and claims management. * Ensure a smooth handover of completed work, project documentation, and lessons learned to construction and ...
Lead project change control, contractor performance reviews, and claims management. * Ensure a smooth handover of completed work, project documentation, and lessons learned to construction and ...
PR · On-site
Guaynabo, PR PBM Claims Analyst is responsible for auditing, analyzing, and tracking accounts receivable related to Pharmacy Benefit Managers (PBMs) at a specialty pharmacy. This role focuses ...
Quick apply
PR · On-site
Guaynabo, PR PBM Claims Analyst is responsible for auditing, analyzing, and tracking accounts receivable related to Pharmacy Benefit Managers (PBMs) at a specialty pharmacy. This role focuses ...
Epic Denials Management Operator
San Juan, PR · Remote
$17.75 - $23.50/hr
Rebill corrected claims and route issues to coding, billing, credentialing, denials, and/or ... Ability to manage and prioritize multiple tasks in a fast-paced and dynamic environment * Strong ...
Epic Denials Management Operator
San Juan, PR · Remote
$17.75 - $23.50/hr
Rebill corrected claims and route issues to coding, billing, credentialing, denials, and/or ... Ability to manage and prioritize multiple tasks in a fast-paced and dynamic environment * Strong ...
PR · On-site
$19/hr
This role is responsible for managing disability claims from intake through resolution, ensuring clients receive timely, accurate, and professional support throughout every stage of the process. The ...
Quick apply
PR · On-site
$19/hr
This role is responsible for managing disability claims from intake through resolution, ensuring clients receive timely, accurate, and professional support throughout every stage of the process. The ...
The Manager of Administrative Coding is part of the leadership team overseeing Optum's Behavioral ... Knowledge of healthcare claims platforms and end-to-end claims operations * Proficiency with ...
The Manager of Administrative Coding is part of the leadership team overseeing Optum's Behavioral ... Knowledge of healthcare claims platforms and end-to-end claims operations * Proficiency with ...
PR · On-site
Manage vendor change orders, claims, warranty terms, and spare-parts strategy. * Ensure compliance with GMP design expectations, materials of construction, and 3-A / ASME BPE where applicable.
Quick apply
PR · On-site
Manage vendor change orders, claims, warranty terms, and spare-parts strategy. * Ensure compliance with GMP design expectations, materials of construction, and 3-A / ASME BPE where applicable.
Project Manager
San Juan, PR · On-site
Manage project change control, contractor claims, and monthly cost and schedule reporting. * Coordinate system turnover activities with Commissioning & Qualification (C&Q) teams. * Collaborate with ...
Project Manager
San Juan, PR · On-site
Manage project change control, contractor claims, and monthly cost and schedule reporting. * Coordinate system turnover activities with Commissioning & Qualification (C&Q) teams. * Collaborate with ...
Cost Manager
San Juan, PR · Hybrid
$130K/yr
Manages cost control, valuations, reporting and final account processes with clarity and accuracy ... Oversees claims, change assessments and key project certifications through strong commercial ...
Cost Manager
San Juan, PR · Hybrid
$130K/yr
Manages cost control, valuations, reporting and final account processes with clarity and accuracy ... Oversees claims, change assessments and key project certifications through strong commercial ...
Execute claims and reverse claims processes, ensuring accuracy, documentation, and timely closure ... Manage activities to shape EM strategy & governance * Coordinate governance forums and track ...
Execute claims and reverse claims processes, ensuring accuracy, documentation, and timely closure ... Manage activities to shape EM strategy & governance * Coordinate governance forums and track ...
Execute claims and reverse claims processes, ensuring accuracy, documentation, and timely closure ... Manage activities to shape EM strategy & governance * Coordinate governance forums and track ...
Execute claims and reverse claims processes, ensuring accuracy, documentation, and timely closure ... Manage activities to shape EM strategy & governance * Coordinate governance forums and track ...
Execute claims and reverse claims processes, ensuring accuracy, documentation, and timely closure ... Manage activities to shape EM strategy & governance * Coordinate governance forums and track ...
Execute claims and reverse claims processes, ensuring accuracy, documentation, and timely closure ... Manage activities to shape EM strategy & governance * Coordinate governance forums and track ...
Senior Cost Manager
San Juan, PR · Hybrid
$130K/yr
Manages cost control, valuations, reporting and final account processes with clarity and accuracy ... Oversees claims, change assessments and key project certifications through strong commercial ...
Senior Cost Manager
San Juan, PR · Hybrid
$130K/yr
Manages cost control, valuations, reporting and final account processes with clarity and accuracy ... Oversees claims, change assessments and key project certifications through strong commercial ...
Facilities Lead/ EHS Manager/ Facilities Supervisor FLSA Status: Exempt Location: Anasco, J&J ... Coordinates worker's compensation claims process and maintains communication with injured employees ...
Facilities Lead/ EHS Manager/ Facilities Supervisor FLSA Status: Exempt Location: Anasco, J&J ... Coordinates worker's compensation claims process and maintains communication with injured employees ...
Facilities Lead/ EHS Manager/ Facilities Supervisor FLSA Status: Exempt Location: Añasco, J&J ... Coordinates worker's compensation claims process and maintains communication with injured employees ...
Facilities Lead/ EHS Manager/ Facilities Supervisor FLSA Status: Exempt Location: Añasco, J&J ... Coordinates worker's compensation claims process and maintains communication with injured employees ...
Claims Manager information
What does a claims manager do?
A Claims Manager oversees the processing and resolution of insurance claims within an organization. Their responsibilities include evaluating claims, ensuring compliance with company policies and legal regulations, and managing a team of claims adjusters or examiners. Claims Managers work to ensure claims are handled efficiently and fairly, often acting as a point of escalation for complex or disputed cases. They also analyze data to improve claims processes and mitigate risk. Effective communication and leadership skills are essential in this role.
What skills and qualifications are needed to be a claims manager?
To thrive as a Claims Manager, you need expertise in insurance policies, risk assessment, and claims processing, usually supported by a degree in business, finance, or a related field. Familiarity with claims management software, regulatory compliance tools, and industry certifications such as AIC (Associate in Claims) is typically required. Strong analytical thinking, negotiation skills, and effective communication help you manage complex cases and lead teams successfully. These skills and qualities are vital for ensuring accurate claims resolution, minimizing financial loss, and maintaining client trust.
How does a claims manager balance high case volumes with thorough and accurate claim assessments?
Claims Managers often face the challenge of managing a large number of claims while maintaining quality and compliance. To address this, they implement efficient workflows, delegate tasks among team members, and use claims management software to automate routine processes. Regular team meetings and performance tracking help ensure that each claim is processed accurately and within regulatory timelines. Strong organizational skills and effective communication are key to balancing these demands and supporting both claimants and internal stakeholders.
What is the difference between Claims Manager vs Claims Adjuster?
| Aspect | Claims Manager | Claims Adjuster |
|---|---|---|
| Credentials | Typically requires a bachelor’s degree, industry certifications (e.g., CPCU), and management experience | Usually requires a high school diploma or bachelor’s degree, with certifications like AIC or CPCU preferred |
| Work Environment | Oversees claims departments, manages teams, and develops policies within insurance companies | Evaluates individual claims, investigates damages, and determines settlement amounts |
| Employer & Industry Usage | Commonly employed in insurance companies, handling claims processes and team management | Found in insurance firms, adjusting claims directly with policyholders and providers |
In summary, Claims Managers oversee the claims process and manage teams, requiring leadership skills and industry certifications. Claims Adjusters focus on evaluating individual claims, investigating damages, and determining payouts. Both roles are essential in the insurance industry but differ in scope and responsibilities.
How much do claims managers make in the US?
Claims managers in the US typically earn a median annual salary of around $80,000 to $100,000, with experienced professionals and those in senior roles earning over $120,000. Salaries vary based on location, industry, and level of experience, and many claims managers hold certifications such as the CPCU or ARM to advance their careers.
What is the role of a claims manager?
A claims manager oversees the processing and settlement of insurance claims, ensuring accuracy and compliance with policies. They evaluate claim validity, coordinate with adjusters and clients, and may use claims management software to streamline operations.
More about Claims Manager jobs
What are the most commonly searched types of Claims jobs in Puerto Rico?
The most popular types of Claims jobs in Puerto Rico are:
What are popular job titles related to Claims Manager jobs in Puerto Rico?
For Claims Manager jobs in Puerto Rico, the most frequently searched job titles are:
What job categories do people searching Claims Manager jobs in Puerto Rico look for?
The top searched job categories for Claims Manager jobs in Puerto Rico are:
What cities in Puerto Rico are hiring for Claims Manager jobs?
Cities in Puerto Rico with the most Claims Manager job openings:
Full-time
Posted 10 days ago
Job description
Casualty Manager
Company: Triple-S Propiedad
Job Location (Short): Guaynabo, PR
Posting Start Date: 8/3/26
At Triple-S, we are committed to providing meaningful job experiences for Valuable People (Gente Valiosa). We strive for excellence in everything we do, from the way we work together to the way we serve our customers.
When you join Triple-S, you will be key to our efforts on delivering high-quality and affordable healthcare as well as contribute to our purpose to enable healthier lives. We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid, Commercial, Life and Property & Casualty Businesses.
Let's build healthier communities together, join now!
JOB SUMMARY
In charge of leading our casualty claims management efforts, overseeing all aspects of claims handling, from investigation to resolution. Is responsible for managing high-risk claims, ensuring compliance with company policies and procedures, and supervising internal and external personnel. As a key member of our claims leadership team, the Casualty Claims Manager will collaborate with internal stakeholders, including the Legal Manager, to drive tactical plans and make strategic decisions that minimize reputational risk and financial exposure. Provides strategic direction to drive tactical plans of the company, in addition to administrative responsibilities and development of its employees.
ESSENTIAL FUNCTIONS
EDUCATION
EXPERIENCE
LICENSES AND CERTIFICATIONS
COMPETENCIES
It is company policy to seek for the qualified applicants for positions throughout the company without distinction of race, color, national origin, religion, sex, gender identity, real or perceived sexual orientation, civil status, social condition, political ideologies, age, physical or mental disability, veteran status or any other characteristic protected by law. Drug-free company.
Equality Employment Opportunity/Affirmative Action for People with Disabilities/Veterans. Employer with E-Verify to verify the eligibility of employment of all the new employees.
We encourage Veterans and Disabled to Apply.
Company: Triple-S Propiedad
Job Location (Short): Guaynabo, PR
Posting Start Date: 8/3/26
At Triple-S, we are committed to providing meaningful job experiences for Valuable People (Gente Valiosa). We strive for excellence in everything we do, from the way we work together to the way we serve our customers.
When you join Triple-S, you will be key to our efforts on delivering high-quality and affordable healthcare as well as contribute to our purpose to enable healthier lives. We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid, Commercial, Life and Property & Casualty Businesses.
Let's build healthier communities together, join now!
JOB SUMMARY
In charge of leading our casualty claims management efforts, overseeing all aspects of claims handling, from investigation to resolution. Is responsible for managing high-risk claims, ensuring compliance with company policies and procedures, and supervising internal and external personnel. As a key member of our claims leadership team, the Casualty Claims Manager will collaborate with internal stakeholders, including the Legal Manager, to drive tactical plans and make strategic decisions that minimize reputational risk and financial exposure. Provides strategic direction to drive tactical plans of the company, in addition to administrative responsibilities and development of its employees.
ESSENTIAL FUNCTIONS
- Supervise and manage legal and non-legal adjusters in the casualty/legal claims area.
- Supervise coverage analysis for all litigated claims and coordinating support for coverage analysis in non-litigated claims.
- Oversee effective investigations of claims, ensuring thorough, accurate and timely reports.
- Manage delegated monetary authority for claims resolution.
- Collaborate with the Legal Manager to develop and implement litigation strategies, including adjustments, expert resources, and budgeting.
- Approve determination of appeal resources, in collaboration with the Legal Manager.
- Oversee approval of billing generated by vendors in claims.
- Manage adequacy of indemnity reserves for casualty/legal claims.
- Administer reporting to reinsurers on claims as required.
EDUCATION
- Bachelor's Degree
EXPERIENCE
- Bachelor's degree from an accredited institution with 10 years of experience in Claims adjustment, vast and extensive knowledge of Property and Casualty Policies and Regulations.
- Puerto Rico All Lines Insurance Adjuster License.
LICENSES AND CERTIFICATIONS
COMPETENCIES
- Customer Delight
- Data Driven Insights
- Develops Talent
- Financial & Business Acumen
- One Company Mindset
- Practical Knowledge in Tech
It is company policy to seek for the qualified applicants for positions throughout the company without distinction of race, color, national origin, religion, sex, gender identity, real or perceived sexual orientation, civil status, social condition, political ideologies, age, physical or mental disability, veteran status or any other characteristic protected by law. Drug-free company.
Equality Employment Opportunity/Affirmative Action for People with Disabilities/Veterans. Employer with E-Verify to verify the eligibility of employment of all the new employees.
We encourage Veterans and Disabled to Apply.