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Claims Manager Jobs in Puerto Rico (NOW HIRING)

Grupo Triple-S

Claims Supervisor

Guaynabo, PR · On-site

Manage and review complex and, or difficult claims or issues to determine best outcome. * Prepares, maintain, and monitor productivity reports and presentations as required by management. * Oversight ...

Grupo Triple-S

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 ...

Assurant, Inc

Sr. Auto Claims Analyst

San Juan, PR

Support alignment between onshore expectations and offshore execution without direct people management. * Data Analysis, Insights & Forecasting * Analyze claims data to identify trends in frequency ...

Deloitte

Epic Denials Manager

San Juan, PR · Remote

Oversight and management of claims and denials management follow-up operations. Analyzes, plans and implements organizational systems and processes, and makes recommendations for improvements in ...

Deloitte

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 ...

JC Automation

Equipment Manager

Carolina, PR · On-site

$150 - $190/hr

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.

PACIV

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 ...

Mace

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 ...

JLL

Professional, Facilities Management

Anasco, PR · On-site

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 ...

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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?

AspectClaims ManagerClaims Adjuster
CredentialsTypically requires a bachelor’s degree, industry certifications (e.g., CPCU), and management experienceUsually requires a high school diploma or bachelor’s degree, with certifications like AIC or CPCU preferred
Work EnvironmentOversees claims departments, manages teams, and develops policies within insurance companiesEvaluates individual claims, investigates damages, and determines settlement amounts
Employer & Industry UsageCommonly employed in insurance companies, handling claims processes and team managementFound 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:

Claims Manager jobs near you
Infographic showing various Claims Manager job openings in Puerto Rico as of August 2026, with employment types broken down into 1% As Needed, 84% Full Time, 12% Part Time, 2% Temporary, and 1% Contract. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution.

Claims Supervisor

Grupo Triple-S

Guaynabo, PR • On-site

Full-time

Re-posted yesterday

Job description

Claims Supervisor
Company: Triple-S Salud
Job Location (Short): Guaynabo, PR
Posting Start Date: 9/1/26
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
The Claims Supervisor performs activities to ensure claims related processes are executed according to standards, policies, procedures, regulations, laws, and guidelines.
ESSENTIAL FUNCTIONS
  • Supervise daily operations and processes within the department by monitoring workflow and inventory, including distribution of work.
  • Train, mentor, motivate, support, and oversee staff.
  • Monitor departmental and individual performance metrics and take proactive action, when necessary, on a timely basis to maintain desired workflow outputs.
  • Monitor vendor performance metrics and take proactive action, on a timely basis to maintain desired workflow outputs, when applicable.
  • Develop and implement workflow changes to improve service and production efficiency of the department; this may include collaboration with other teams.
  • Collaborate with other teams to implement new and revised policies and procedures, which may include suggested system changes or enhancements.
  • Partner with internal and external contacts to achieve effective communications and maximum efficiency.
  • May act as a liaison in monitoring and supporting specific topic or departmental assignments through reporting and relationship building.
  • Select, develop, and evaluate staff to ensure the efficient operation of department.
  • Demonstrate Company's Core Competencies and values held within.
  • Participate in internal and external audits (i.e but not limited to Compliance, CMS, ASES, SOX, MTM, etc.)
  • Stay up to date on local, state, and federal changes in regulations and laws to anticipate impact, new requirements, and potential changes in operational processes.
  • Ensure legal compliance by following company policies, procedures, and guidelines as mandated by state and federal legislation and, or health plan or company directives. Alert non-compliance issues, coordinate and manage corrective action plans
  • Oversight and, or act as SME on projects, initiatives and, or issues impacting claims operations and contribute with knowledge and experience. Research claim processing problems and errors to determine their origin and appropriate resolution.
  • Manage and review complex and, or difficult claims or issues to determine best outcome.
  • Prepares, maintain, and monitor productivity reports and presentations as required by management.
  • Oversight all claims dependencies delegated to the different operational areas until full resolution to ensure the resolution of any incoming inquiries related to claims processes.
  • Supervise and monitor the creation and submission of regulatory reports to ensure the compliance in a correct and timely manner and comply with metrics.
  • Communicate with management regarding trends to improve claims processing accuracy.
  • Document business rules for incorporation into training programs and assist with the training of new employee and vendor staff.

EDUCATION
  • Bachelor's Degree in Natural Science or Arts

EXPERIENCE
Bachelor's Degree (BD) in Natural Science, Arts or Business Administration preferable with three (3) to five (5) years of experience in the Claims processing preferable in a health insurance industry analysis, investigation, auditing and/or risk management in a Healthcare setting.
LICENSES AND CERTIFICATIONS
  • None required

COMPETENCIES
  • Financial & Business Acumen
  • Data Driven Insights
  • Customer Delight
  • One Company Mindset
  • Develops Talent
  • 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.

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