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Claims Resolution Manager Jobs in Missouri (NOW HIRING)

Claims recovery and reimbursement specialists * Insurance defense professionals * Non-practicing J ... Resolution Managers are trusted to own settlement strategy, negotiate directly with opposing ...

Senior Resolution Manager

Creve Coeur, MO ยท On-site

$75K - $90K/yr

Claims recovery and reimbursement specialists * Insurance defense professionals * Non-practicing J ... Resolution Managers are trusted to own settlement strategy, negotiate directly with opposing ...

Senior Resolution Manager

Creve Coeur, MO ยท On-site

$90 - $120/hr

Senior Resolution Manager Intellivo is seeking a highly skilled Sr. Resolution Manager to join our ... Claims recovery and reimbursement specialists * Insurance defense professionals * Nonโ€‘practicing ...

Claims recovery and reimbursement specialists * Insurance defense professionals * Non-practicing J ... Resolution Managers are trusted to own settlement strategy, negotiate directly with opposing ...

Claims Manager

Fenton, MO ยท On-site

$25K/mo

... resolution. * Authorizes settlements, compromises, and pays claims up to $25,000. * Attends regular ... Manages third-party medical bill audits for all self-handled medical expenses. * Generates reports ...

... resolution. * Authorizes settlements, compromises, and pays claims up to $25,000. * Attends regular ... Manages third-party medical bill audits for all self-handled medical expenses. * Generates reports ...

... resolution. * Authorizes settlements, compromises, and pays claims up to $25,000. * Attends regular ... Manages third-party medical bill audits for all self-handled medical expenses. * Generates reports ...

... resolution. * Authorizes settlements, compromises, and pays claims up to $25,000. * Attends regular ... Manages third-party medical bill audits for all self-handled medical expenses. * Generates reports ...

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Claims Resolution Manager information

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 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 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.

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.

What are the most commonly searched types of Claims Resolution jobs in Missouri?

The most popular types of Claims Resolution jobs in Missouri are:

What cities in Missouri are hiring for Claims Resolution Manager jobs?

Cities in Missouri with the most Claims Resolution Manager job openings:

Senior Resolution Manager

Intellivo

Creve Coeur, MO โ€ข On-site

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 15 days ago


Job description

Senior Resolution Manager

About the Role 

Intellivo is seeking a highly skilled Sr. Resolution Manager to join our growing STL Attorney Team. This role is designed for professionals who thrive in high-stakes negotiations and enjoy driving complex matters to successful resolution. 


As a Sr. Resolution Manager, you will negotiate directly with plaintiff attorneys and legal representatives, develop settlement strategies, finalize liens, and maximize recoveries for some of the nation's largest health plans. You will manage attorney-involved matters that require advanced negotiation expertise but do not require a law license. 


Resolution Managers are responsible for independent negotiation strategy, settlement authority recommendations, and financial outcomes on attorney-involved matters. Unlike traditional recovery or adjuster roles, Resolution Managers are expected to evaluate complex legal and factual issues, determine resolution strategy, and drive high-value matters to settlement completion with limited supervision. 


Who Is a Good Fit? 

We recognize that great negotiators come from many different backgrounds. Candidates who have been successful in roles requiring complex negotiations, settlement strategy, financial analysis, and direct interaction with attorneys often excel as Resolution Managers. 

Strong candidates may come from backgrounds such as: 

  • Personal injury case managers and settlement coordinators 
  • Workers' compensation settlement specialists 
  • Senior bodily injury or large-loss adjusters 
  • Litigation paralegals 
  • Healthcare recovery and subrogation professionals 
  • Claims recovery and reimbursement specialists 
  • Insurance defense professionals 
  • Non-practicing J.D.s seeking a business-focused negotiation career 


This role is ideal for professionals who enjoy strategy, advocacy, and financial negotiations and who are looking to apply their expertise in a high-impact, performance-driven environment. Resolution Managers are trusted to own settlement strategy, negotiate directly with opposing counsel, and drive meaningful financial outcomes for some of the nation's largest health plans. 


Key Responsibilities 

  • Serve as the primary escalation point for complex negotiations and settlement disputes within assigned inventory. 
  • Resolve matters that exceed standard recovery workflows or require advanced negotiation expertise. 
  • Mentor and provide guidance to less experienced recovery professionals regarding negotiation strategy and settlement positioning. 
  • Negotiate directly with plaintiff attorneys, defense counsel, and legal representatives. 
  • Develop and execute settlement strategies for complex recovery matters. 
  • Evaluate settlement opportunities, reduction requests, and recovery potential. 
  • Finalize liens, settlement resolutions, and file closures. 
  • Manage a portfolio of attorney-involved recoveries from negotiation through resolution. 
  • Partner with Attorneys on matters requiring legal analysis or litigation strategy. 
  • Maximize recoveries while maintaining efficient resolution timelines. 


Qualifications 


Required 

  • 5+ years of experience in settlement negotiations, subrogation, claims recovery, lien resolution, workers' compensation, personal injury, insurance defense, healthcare reimbursement, or related field. 
  • Demonstrated success influencing outcomes and resolving complex disputes through negotiation. 
  • Experience communicating and negotiating with attorneys, insurance carriers, claim representatives, or other sophisticated stakeholders. 
  • Strong analytical, financial, and strategic thinking skills with the ability to evaluate settlement opportunities and recovery potential. 
  • Excellent verbal communication skills, including the ability to confidently negotiate by phone in challenging or adversarial situations. 
  • Ability to independently manage a high-volume portfolio while achieving performance and recovery goals. 
  • Proven ability to exercise sound judgment, make independent decisions, and drive matters to resolution. 


Preferred 

  • Experience in healthcare subrogation, reimbursement recovery, lien resolution, or settlement allocation negotiations. 
  • Experience negotiating directly with plaintiff attorneys or defense counsel. 
  • Background as a lien negotiator, settlement coordinator, litigation paralegal, personal injury case manager, workers' compensation specialist, bodily injury adjuster, large-loss adjuster, or recovery professional. 
  • Experience managing attorney-represented claims or recovery matters. 
  • Proven track record of achieving measurable financial results through negotiation and settlement strategy. 


Who is Intellivo?

As an industry market leader in subrogation, Intellivo empowers health plans and insurers to maximize financial outcomes by identifying and pursuing more reimbursement opportunities from alternative third-party liability (TPL) payers. Through innovative technology, Intellivo accelerates the identification of reimbursement opportunities while completely eliminating the need to fill information gaps through ineffective and burdensome outreach to plan members. With a 26-year history of excellence, Intellivo proudly represents more than 200 of the country’s largest health plans. 


Why work for Intellivo?

Imagine a place where your talent is valued, and performance is rewarded. We are a collaborative team focused on solving complex challenges on the financial side of healthcare.

  • A team that values partnership, accountability, and results
  • Medical Insurance
  • Dental & Vision Insurance
  • Industry-leading health & wellness benefits
  • 401(k) retirement plan
  • Paid Time Off
  • And more!


This is an on site role in our St. Louis, MO office.


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