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Claims Resolution Manager Jobs in California (NOW HIRING)

Cna

General Liability Claims Consultant

Brea, CA · Hybrid

$72K - $141K/yr

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 ...

Mercury Insurance Services, LLC

Claims Representative

CA · On-site

$32K - $56K/yr

... resolution and manage a high volume of claims. • Has a passion for serving customers in their time of need. • Possesses effective written and verbal communication skills to professionally ...

WellPsyche

Claims Follow-Up Lead-CA

Los Angeles, CA · Remote

$25 - $30/hr

... Claims Resolution (Primary Function) * Follow up on denied, underpaid, and aged behavioral health claims. * Work complex government payers including: * Medi-Cal / Medicaid (FFS & Managed Care)

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All JobsClaims Resolution JobsClaims Resolution Manager JobsClaims Resolution Manager Jobs in California

Claims Resolution Manager information

What is the difference between Claims Resolution Manager vs Claims Adjuster?

AspectClaims Resolution ManagerClaims Adjuster
CredentialsInsurance licenses, sometimes management certificationsInsurance licenses, specific to claims handling
Work EnvironmentSupervisory roles, team coordinationField or office-based, claims investigation
Employer & Industry UsageInsurance companies, claims departmentsInsurance companies, third-party administrators
Search & Comparison IntentUnderstanding managerial roles in claimsDetails about claims handling and investigation

The Claims Resolution Manager oversees claims processes and manages teams, focusing on strategy and resolution. Claims Adjusters handle the investigation and evaluation of individual claims. While both roles require insurance licenses, the manager's role is more supervisory, whereas the adjuster is more hands-on with claims investigation.

Is claims processing a stressful job?

Claims resolution managers often handle complex cases and tight deadlines, which can contribute to workplace stress. The job requires strong organizational skills and attention to detail, but stress levels vary depending on workload and company support systems.

What does a claims resolution manager do?

A Claims Resolution Manager oversees the process of handling insurance claims from initiation to closure, ensuring that claims are resolved efficiently and fairly. They investigate claim details, coordinate with adjusters, clients, and third parties, and work to resolve disputes or issues that may arise during the claims process. Their goal is to ensure compliance with company policies and legal regulations while optimizing customer satisfaction and minimizing losses for the organization.

What are the key skills and qualifications needed to thrive as a claims resolution manager, and why are they important?

To thrive as a Claims Resolution Manager, you need a solid background in insurance claims processing, dispute resolution, and regulatory compliance, often supported by a bachelor's degree in business, finance, or a related field. Familiarity with claims management software, CRM tools, and relevant certifications such as AIC or CPCU is common. Strong analytical thinking, negotiation skills, and effective communication are crucial soft skills for managing complex cases and guiding teams. These abilities ensure efficient claims handling, customer satisfaction, and minimized financial risk for the organization.

How much do claims resolution managers make in the US?

Claims resolution managers in the US typically earn a median annual salary of around $70,000 to $90,000, depending on experience, location, and the size of the employer. Salaries can vary based on industry, certifications, and the complexity of claims handled.

What are the primary challenges a claims resolution manager faces when balancing client expectations with policy limitations?

Claims Resolution Managers often navigate the delicate balance between meeting client expectations and adhering to insurance policy terms. One common challenge is communicating complex policy details to clients who may be experiencing stress or frustration. Additionally, managers must ensure timely and fair claims processing while coordinating with adjusters, legal teams, and external vendors. Success in this role requires strong negotiation skills, empathy, and a thorough understanding of regulatory and company guidelines.
What cities in California are hiring for Claims Resolution Manager jobs? Cities in California with the most Claims Resolution Manager job openings:
Claims Resolution Manager jobs near you

Reconstruction Claims Adjuster (In-Person Position)

Alert Disaster Restoration

Bakersfield, CA • On-site

Full-time

Re-posted 4 days ago

Job description

Salary: $70,000-$105,000 plus bonus structure

Position Title: Reconstruction Claims Adjuster (In-Person Position)


Job Summary: As an experienced property claims adjuster (in-person position), you will be responsible for managing and processing insurance claims from start to finish. You will utilize your expertise in claims handling and policy interpretation to investigate, evaluate, and settle claims accurately and efficiently. Your primary focus will be on achieving approvals, writing/coordinating accurate scopes of work, negotiating with carrier and independent adjusters and supporting ADR Project Supervisors in achieving client satisfaction and company gross profit standards.


Key Responsibilities:

  1. Claim Processing: Receive and review documentation from work performed/needed submitted by internal departments, ensuring all required documentation and information are complete and accurate.
  2. Damage Evaluation: Assess the extent of damages or losses claimed, utilizing established methodologies, industry standards, and company guidelines to determine fair and equitable invoice and scope writing.
  3. Negotiation and Settlement: Negotiate settlement terms with claimants or their representatives, using effective communication and negotiation skills to reach mutually acceptable agreements within established authority limits.
  4. Documentation and Reporting: Maintain detailed records of claim activities, correspondence, and settlement agreements in the company's claims management system, ensuring accuracy, completeness, and compliance with regulatory standards.
  5. Property Restoration Project Sales
  6. Customer Service: Provide courteous, responsive, and empathetic customer service to policyholders, adjusters, claimants, and other stakeholders throughout the claims process, addressing inquiries, providing updates, and offering assistance and guidance as needed.
  7. Collaboration: Collaborate with internal departments, to facilitate claims resolution, mitigate risks, and ensure consistency in claims handling practices.

Qualifications:

  • 4 Years insurance claims adjusting and large loss experience, with a demonstrated proficiency in handling property, or other relevant lines of insurance.
  • Must have strong construction knowledge
  • Highly skilled in Xactimate
  • Proficiency in computer software and claims management systems, with the ability to navigate multiple systems simultaneously.
  • Excellent communication, negotiation, and problem-solving skills, with a customer-focused mindset and a commitment to delivering exceptional service.
  • Relevant industry certifications (e.g., Xactimate Certified, AIC, CPCU, IICRC, etc.)

Working Conditions:

  • Standard office hours with occasional flexibility based on workload demands. This is an in-person position.
  • Collaborative team environment with opportunities for professional growth and development.


This job description emphasizes the role of an experienced claims adjuster primarily working in an office environment, managing and processing claims efficiently while maintaining a focus on customer service and compliance. Adjustments can be made based on specific organizational requirements or industry nuances.