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Claims Resolution Manager Jobs in Minnesota (NOW HIRING)

Trice Healthcare

Coding Payment Resolution Spec

Greenwald, MN · On-site

$18.75 - $24.25/hr

Coding Payment Resolution Specialist Responsible for reviewing all post-billed denials (inclusive ... managed care organization or other health care financial service setting, performing medical claims ...

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All JobsClaims Resolution JobsClaims Resolution Manager JobsClaims Resolution Manager Jobs in Minnesota

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 Minnesota are hiring for Claims Resolution Manager jobs? Cities in Minnesota with the most Claims Resolution Manager job openings:
Claims Resolution Manager jobs near you

Unpaid Claims Representative

Nystrom & Associates

New Brighton, MN • On-site, Remote

$20 - $22/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 22 days ago

Nystrom & Associates rating

7.4

Company rating: 7.4 out of 10

Based on 22 frontline employees who took The Breakroom Quiz

Job description

Location:1200 County Road E., Arden Hills, MN 55112, United States

Working Model: Remote - Minnesota

Employee Type: 1.0

Schedule: Monday through Friday 7:00 AM -3:30 PM

AtSagentBehavioral Health, we believe profound change is possible. As one of the largest behavioral health organizations in the Midwest-with 2,000+ team members across 80+ locations in five states-we offer the stability and resources to help you thrive.
Backed by more than 100 years of combined behavioral health experience,Sagentbrings together the trusted legacies of Ellie Mental Health, LifeWorks, Nystrom & Associates, Psychiatric Associates, Sandhill Counseling & Consultation, and Vantage Point.
Here,you'llfind a supportive, inclusive culture where you can hone your skills, collaborate with a fantastic team, and build a rewarding career focused on what matters most: helping others find hope. Guided by our HOPE values-Humility, Optimism, People-Centered, and Ethical Practice-we provide manageable caseloads, flexible schedules, and compensation options that work for you-from salary to production-based models.

As a Unpaid Claims Representative at Sagent Behavioral Health, you will play a critical role in supporting the timely and accurate processing of insurance claims within our Business Office. You will ensure outstanding claims are followed up on, resolved, and billed appropriately, helping maintain smooth revenue cycle operations for our mental health services. This position requires strong attention to detail, effective communication, and a commitment to resolving claim issues efficiently.

Full Time Benefits:

  • Medical, Dental, Vision

  • 401k, Long Term Disability, Short Term Disability and Life Insurance

  • PTO and Time Off

Responsibilities:

    • Follow up on unpaid insurance claims for assigned payers to ensure timely resolution.
    • Investigate each denied or rejected claim thoroughly and determine the necessary corrective actions.
    • Resubmit or appeal claims as needed to secure proper reimbursement.
    • Communicate directly with insurance companies to gather information, clarify denials, and resolve issues.
    • Respond promptly to inquiries from Providers, Patient Financial Services, and the Insurance Team.
    • Maintain a strong understanding of insurance guidelines, billing rules, and interpretation of EOBs.
    • Identify recurring issues or trends with specific insurance companies and escalate as appropriate.
    • Perform additional duties as assigned by management to support departmental operations.

Requirements:

      • At least 6+ months of experience in the Sagent Behavioral Health's Business Office or comparable claims/AR experience.
      • Familiarity with insurance company guidelines, billing procedures, and claim adjudication processes.
      • Strong attention to detail, problem-solving skills, and a positive, team-oriented mindset.
      • Proficiency with Microsoft Windows, Excel, Word, and Outlook.
      • High school diploma or equivalent, with strong organizational and multitasking abilities.

Compensation: $20.00-$22.00/hr

*Actual compensation may bedeterminedbyvarious factorssuch as education, experience, skillset, internal equity,scheduleand/or location.

* Employees in these positions are W2.

SagentBehavioral Health is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

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