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Claims Processing Manager Jobs in Connecticut (NOW HIRING)

Makes recommendations on claims processes and resolution strategies to management. * Analyzes claims activities; prepares and presents reports to management and other internal business partners and ...

In a fast-paced environment, you'll learn how to resolve a full case load of claims efficiently while managing the claims process from start to finish. You'll have the support of a collaborative team ...

The Manager, Out-of-Network Claims Negotiation is responsible for leading the strategy, operations ... trends, identify process improvement opportunities, and help shape the ongoing evolution of ...

This role requires strong knowledge of healthcare claims processing, encounter reporting, the 837 claims transaction standard, and state-specific submission requirements. The Manager will be ...

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Claims Processing Manager information

What does a claims processing manager do?

A Claims Processing Manager oversees the team responsible for reviewing, evaluating, and processing insurance claims. Their duties include ensuring claims are handled efficiently and accurately, developing procedures to improve workflow, and maintaining compliance with industry regulations. They also resolve complex or escalated claims issues, provide staff training, and report on performance metrics. The role requires strong leadership, analytical skills, and attention to detail to ensure a fair and timely claims process.

What are the key skills and qualifications needed to thrive as a claims processing manager?

To thrive as a Claims Processing Manager, you need expertise in insurance claims procedures, analytical skills, and a solid understanding of regulatory compliance, often supported by a bachelor's degree and relevant industry experience. Familiarity with claims management software, workflow automation tools, and data analysis systems is typically required. Strong leadership, attention to detail, and effective communication are crucial soft skills that set top performers apart in this role. These abilities ensure accurate and efficient claims processing, regulatory adherence, and effective team management, all of which are vital for organizational success.

What are the primary challenges faced by a claims processing manager, and how can they be addressed?

Claims Processing Managers often navigate challenges such as ensuring timely and accurate claim adjudication, managing a team with varying workloads, and staying up to date with regulatory changes. Balancing efficiency with compliance requires strong organizational skills and effective communication. Successful managers foster a collaborative environment, implement regular training, and leverage technology to streamline processes, all while maintaining high standards of customer service and data integrity.

What are the most commonly searched types of Claims Processing jobs in Connecticut?

The most popular types of Claims Processing jobs in Connecticut are:

What cities in Connecticut are hiring for Claims Processing Manager jobs?

Cities in Connecticut with the most Claims Processing Manager job openings:

General Liability Claims Consultant

Cna

Glastonbury, CT • Hybrid

$72K - $141K/yr

Full-time

Posted 27 days ago


Job description

You have a clear vision of where your career can go. And we have the leadership to help you get there.At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.

You have a clear vision for where your career can go - and at CNA, we're committed to helping you get there. We foster a culture where people know they matter, feel connected to meaningful work, and are supported in using their talents to their fullest potential.
This individual contributor role operates under broad authority to manage commercial claims of high complexity and exposure within the Commercial Auto/General Liability/ Construction Auto and General Liability line(s) of business. The position is responsible for coordinating all aspects of the claim resolution process in accordance with company guidelines, while consistently delivering high-quality outcomes and strong customer service. Regular communication with customers, insureds, and other stakeholders is required, and the role may support designated accounts. This position offers a flexible, hybrid work schedule, requiring 2 days in a CNA office per week.

JOB DESCRIPTION:

Essential Duties & Responsibilities
Performs a combination of duties in accordance with departmental guidelines:

  • Manages highly complex investigations of claims, including coverage issues, liability, compensability and damages. Determines if a major claim should be settled or litigated and implements an appropriate resolution strategy accordingly. Effectively manages loss costs and claim expenses.
  • Manages all types of investigative activity or litigation on major claims, including the posting of appropriate reserves in a timely manner. Coordinates discovery and litigation strategy with staff counsel or panel attorneys.
  • Negotiates highly complex settlement packages, and authorizes payment within scope of authority, settling claims in most cost effective manner and ensuring timely issuance of disbursements.
  • Coordinates third party recovery with subrogation/salvage unit.
  • Makes recommendations on claims processes and resolution strategies to management.
  • Analyzes claims activities; prepares and presents reports to management and other internal business partners and clients.
  • Works with attorneys, account representatives, agents, doctors and insureds regarding the handling and/or disposition of highly complex claims.
  • Keeps current on state/territory regulations and issues, industry activity and trends. May participate in industry trade groups.
  • Provides guidance and assistance to less experienced claims staff and other functional areas.
  • Responsible for input of data that accurately reflects claim circumstances and other information important to our business outcomes.

Reporting Relationship
Manager or above.

Skills, Knowledge and Abilities

  • Advanced technical and product specific expertise, claims resolution skill and knowledge of insurance and claims principles, practices and procedures.
  • Strong communication, negotiation and presentation skills. Ability to effectively interact with all levels of CNA's internal and external business partners.
  • Advanced analytical and problem solving skills, with the ability to manage and prioritize multiple projects.
  • Ability to deal with ambiguous situations and issues.
  • Creativity in resolving unique and challenging business problems.
  • Knowledge of Microsoft Office Suite and other business-related software.
  • Ability to adapt to change and value diverse opinions and ideas.
  • Ability to manage and prioritize multiple projects.
  • Ability to evaluate claims based on a cost benefit analysis.
  • Ability to fully comprehend complex claim facts and issues; and to further articulate analyses of claims in presentations to business partners and management as well as in internal reports.
  • Ability to implement strategies with a proactive long-term view of business goals and objectives.


Education and Experience

  • Bachelor's degree or equivalent experience.
  • Professional designation preferred.
  • Typically a minimum eight years claims experience.

#LI-AR1

#LI-Hybrid

In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $72,000 to $141,000 annually.Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visitcnabenefits.com.


CNAutilizesAI-enabled technology during the recruiting process. For more information, please visitourcareers page.


CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contactleaveadministration@cna.com