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Claims Resolution Manager Jobs in Virginia (NOW HIRING)

Markel International

Associate Claims Examiner

Richmond, VA · Hybrid

$17.50 - $23.75/hr

Mentor with senior examiners and managers to observe negotiation strategies and claim resolution practices. * Collaborate with departments across Markel including Claims Vendor Management, Finance ...

ALKEME

Commercial Lines Claims Associate

Glen Allen, VA · On-site

$16.50 - $22.25/hr

The Commercial Lines Claims Associate role is responsible for supporting the day-to-day operations of the Claims Division while managing commercial liability claims from initiation to resolution.

Kinsale Insurance

Associate Claims Examiner

Richmond, VA · On-site

$70K - $73K/yr

Managing a desk of low-to-moderately complex Property and Liability claims under the supervision of ... Determining liability, assessing exposure, and negotiating claims through to resolution.

Kinsale Insurance

Associate Claims Examiner

Richmond, VA · On-site

$70K - $73K/yr

Managing a desk of low-to-moderately complex Property and Liability claims under the supervision of ... Determining liability, assessing exposure, and negotiating claims through to resolution.

thg

Technical Consultant Casualty Claims

Syracuse, NY · Hybrid

The Technical Consultant, Casualty Claims, manages moderate to complex and high-value casualty and ... The consultant analyzes complex data, provides expert opinions to support claim resolution, and may ...

Odyssey

Senior Claims Specialist 1

Richmond, VA · On-site

... resolution of complex, high-exposure general liability claims, with a strong emphasis on ... This role manages claims involving bodily injury, property damage, product liability, contractual ...

Cna

Claims Consultant, Life Sciences

Glen Allen, VA · On-site

Establishes and manages claim budgets by achieving timely claim resolution, selecting and actively ... and claims are resolved and paid timely. * Keeps leadership informed of significant risks and ...

thg

Auto PD - Adjuster Service Claims

Richmond, VA · Hybrid

$49K - $63K/yr

Manage a caseload of moderately complex service claims from intake through resolution. * Conduct thorough investigations, assess liability, and evaluate damages using established procedures. * Engage ...

thg

Auto PD - Adjuster Service Claims

Howell, MI · Hybrid

$46K - $60K/yr

Manage a caseload of moderately complex service claims from intake through resolution. * Conduct thorough investigations, assess liability, and evaluate damages using established procedures. * Engage ...

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All JobsClaims Resolution JobsClaims Resolution Manager JobsClaims Resolution Manager Jobs in Virginia

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.
Claims Resolution Manager jobs near you

Insurance Account Resolution Specialist - Digitech - Remote

Sarnova HC, LLC

Boydton, VA • On-site, Remote

$13.75 - $19.25/hr

Full-time

Retirement

Posted 17 days ago

Sarnova rating

8.2

Company rating: 8.2 out of 10

Based on 11 frontline employees who took The Breakroom Quiz

Job description

The Sarnova Family of companies includes Digitech Computer, Bound Tree Medical, Tri-anim Health Services and Cardio Partners.
Digitech is a leading provider of advanced billing and technology services to the EMS transport industry. Since its founding in 1984, Digitech has refined its software platform to create a cloud-based billing and business intelligence solution that monitors and automates the entire EMS revenue lifecycle. Digitech leverages its proprietary technology to offer fully outsourced services that maximize collections, protect compliance, and deliver results for clients.
Summary:
Digitech is seeking a highly motivated and detail-oriented Insurance Account Resolution Specialist to manage and resolve insurance claims after submission to commercial insurance carriers. This role is responsible for ensuring timely, accurate, and compliant claim resolution by reviewing pending, denied, or incorrectly paid claims and following through until payment is secured. Success in this role requires strong analytical skills, excellent follow-through, and the ability to manage a high-volume workload in a fast-paced environment.
This is a remote, work-from-home position, operating Monday through Friday during standard business hours, aligned with the team's 8:00am-4:30pm Eastern Time schedule.
Essential Duties and Responsibilities:
  • Research and resolve outstanding insurance claims, including those that are pending, unable to be released, denied, or paid incorrectly by commercial insurance carriers
  • Investigate claims placed on hold, identifying root causes, correcting errors, and executing needed follow-up actions to release claims for processing
  • Analyze insurance denials, determining denial reasons, assessing validity, and completing the appropriate resolution steps such as appeals, corrections, or resubmissions
  • Communicate directly with insurance carriers via outbound calls to obtain claim status, clarify discrepancies, and secure detailed explanations for pending or denied claims
  • Prepare and submit additional documentation requested by insurance carriers to support claim adjudication and ensure accurate processing
  • Draft and submit appeals when necessary, ensuring they are supported by proper documentation, regulatory guidelines, and payer-specific requirements
  • Process and manage incoming correspondence, including mail, emails, EOBs, requests for information, and any necessary refunds
  • Maintain accurate, detailed notes in billing systems for all follow-up activities, findings, and next steps
  • Identify trends or recurring issues, escalating concerns to supervisors or appropriate internal teams to support process improvement
  • Meet daily productivity and accuracy expectations, contributing to a high-performing team environment
  • Additional job duties as assigned

Skills/Experience Required:
  • Education: High School Diploma or equivalent required
  • Strong computer skills, including working knowledge of MS Outlook, Word, and Excel
  • Ability to type 40 WPM with accuracy
  • Proven ability to handle high-volume workloads, prioritize effectively, and meet tight deadlines
  • Experience in a structured environment where call monitoring, performance metrics, or productivity scoring are used is helpful
  • Strong verbal communication skills with the ability to remain calm, professional, and effective during phone interactions with insurance carriers
  • Excellent written communication skills for crafting clear, accurate documentation and correspondence
  • Exceptional attention to detail and accuracy in reviewing claims, identifying discrepancies, and documenting findings
  • Highly organized, self-paced, and capable of managing work independently in a remote environment
  • Dependable, punctual, and accountable, with a willingness to ask questions and seek clarification when needed
  • Ability to independently manage all aspects of the job role including required goals and business practices in a remote environment

Sarnova is an Equal Opportunity Employer. We offer a competitive salary, commensurate with experience, along with a comprehensive benefits package, including 401(k) Plan. EO/M/F/Veterans/Disabled.
Our mission is to be the best partner for those who save and improve patients' lives. Excellence in delivering upon our mission is dependent upon having a diverse team that is empowered to bring their full, authentic self to work each day. We strive to create a workplace that reflects the communities we serve, and we are passionate about creating an inclusive workplace that promotes and values diversity.
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