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Claims Risk Management Jobs (NOW HIRING)

Salt Lake County

Risk Management Dir

Salt Lake City, UT · On-site

$102K - $154K/yr

JOB SUMMARY Oversees Risk Management for Salt Lake County as part of the Civil Division of the ... Works closely with civil attorneys in representing the County in claims and any resulting ...

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$35K

$87.9K

$139K

How much do claims risk management jobs pay per year?

As of Jun 5, 2026, the average yearly pay for claims risk management in the United States is $87,861.00, according to ZipRecruiter salary data. Most workers in this role earn between $68,000.00 and $105,000.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in Claims Risk Management, and why are they important?

To thrive in Claims Risk Management, you need a solid understanding of insurance policies, risk assessment, and claims processing, often supported by a degree in business, finance, or insurance-related fields. Familiarity with claims management systems, data analytics tools, and relevant certifications such as AIC or CPCU is highly valuable. Strong analytical thinking, attention to detail, and effective communication are essential soft skills for evaluating claims and collaborating with stakeholders. These competencies ensure accurate risk evaluation, minimize financial loss, and maintain compliance within an organization.

What is Claims Risk Management?

Claims Risk Management refers to the process of identifying, evaluating, and mitigating risks related to insurance claims. Professionals in this field analyze claim trends, investigate potential fraud, and implement strategies to reduce the frequency and severity of claims. Their goal is to protect the financial interests of the insurer while ensuring fair treatment of policyholders. Effective claims risk management helps companies minimize losses and improve operational efficiency.

What are some common challenges faced in a Claims Risk Management role, and how can they be addressed?

Professionals in Claims Risk Management often face challenges such as balancing the need for thorough claim investigations with the pressure to resolve cases quickly, staying updated on changing regulations, and detecting potential fraud. To address these challenges, it's important to develop strong analytical skills, maintain open communication with legal and underwriting teams, and participate in ongoing industry training. Building collaborative relationships within the organization also helps streamline processes and foster a proactive approach to risk mitigation.

What is the difference between Claims Risk Management vs Claims Adjuster?

AspectClaims Risk ManagementClaims Adjuster
Primary FocusIdentifying and mitigating risks to prevent claimsInvestigating and settling individual insurance claims
CertificationsRisk management certifications (e.g., CRM, ARM)Adjuster licenses and certifications
Work EnvironmentOffice-based, strategic planningFieldwork, claims sites, or office
Industry UsageInsurance companies, risk management firmsInsurance carriers, third-party claims companies

Claims Risk Management professionals focus on reducing overall claim risks through analysis and strategy, while Claims Adjusters handle individual claims, investigating and settling them. Both roles are essential in the insurance industry but serve different functions.

More about Claims Risk Management jobs
What cities are hiring for Claims Risk Management jobs? Cities with the most Claims Risk Management job openings:
What states have the most Claims Risk Management jobs? States with the most job openings for Claims Risk Management jobs include:
What job categories do people searching Claims Risk Management jobs look for? The top searched job categories for Claims Risk Management jobs are:
Claims Risk Management jobs near you
Risk Management Analyst

Risk Management Analyst

Hackensack Meridian Health

Neptune, NJ • On-site

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 15 days ago

Hackensack Meridian Health rating

7.8

Company rating: 7.8 out of 10

Based on 350 frontline employees who took The Breakroom Quiz

131st of 865 rated healthcare providers

Job description

Overview
Our team members are the heart of what makes us better.
At Hackensack Meridian Health we help our patients live better, healthier lives - and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It's also about how we support one another and how we show up for our community.
Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.
The Risk Management Analyst (RMA) is responsible for investigating risk management events, reviewing and analyzing events in the ONElink event reporting system, assisting with proactive risk management educational initiatives, working on various insurance matters, as well as assisting with claims and litigation matters on a day-to-day basis for the various lines of coverage for multiple sites within the Hackensack Meridian Health Care System. The RMA shall be responsible for legal research, discovery requests, and maintenance of files and statistical reports. The RMA shall work closely with internal and external counsel, the medical claims TPA, and insurance broker representatives. This position interacts with all levels in the organization along with the Enterprise Risk Management team toward the goal of improving safe and trusted healthcare. This position reports to the Director, Enterprise Risk Management.
Responsibilities
A day in the life of a Risk Management Analyst at Hackensack Meridian Health includes:
  • Investigates risks involving actual or potential injury to patients, visitors and team members
  • Assists with the review, investigation, follow up and closure of ONElink event reports
  • Prepares and provides statistical data, graphs and various other reports from the ONElink system/other systems for Enterprise Risk Management and other ad hoc requests; presents and explains relevant trends, data, and outcomes to a variety of audiences.
  • Makes appropriate referrals to Managers, Internal Quality Improvement teams, Peer Review Committees for appropriate follow-up to reduce risk of recurrence.
  • Responsible for additions and deletions of team member access and updates in the ONElink system
  • Assists in the process of accepting Subpoenas, and Summonses and Complaints
  • Investigates and analyzes claims/litigation and potential claims upon receipt.
  • Obtains and sequesters evidence
  • Obtains visit history and pertinent medical records
  • Notifies the liability insurance carrier of actual and potential claims
  • Obtains insurance information and partners with insurance team to determine coverage analysis
  • Processes claims with the appropriate carrier(s) and broker within policy period
  • Obtains coverage determinations, and partners with the risk leader to resolve unfavorable determinations
  • Coordinates day-to day discovery (document production, interrogatories, scheduling interviews and depositions)
  • Maintaining a positive working relationship with the hospital's professional and general liability insurance carrier and general counsel.
  • Working in coordination with the Director of Risk Management reply to requests from the hospital's legal counsel.
  • Obtains reimbursement from carriers as appropriate on first party claims (eg., auto and property)
  • Maintains current knowledge of status of all claims and litigation matters and keeps Risk Management leaders/team apprised of changes
  • Performs legal research as needed
  • Keeps abreast of healthcare risk management issues, assisting with implementation of new or revised guidelines and practices 21. Maintains the confidentiality and integrity of all information encountered during work activities.
  • Audits expenses and processes payments as needed
  • Maintains up-to-date claims run at all times and updates relevant parties on a quarterly basis and as needed
  • Maintains appropriately organized litigation files; including electronic and paper claim files;
  • Prepares materials for quarter claim and steering committee meetings
  • Acts as a liaison with insurance brokers for requests from various department
  • Assists the Corporate Insurance Department with the professional liability insurance coverage process which includes collaboration with the Medical Staff Office, Human Resources and our insurance broker
  • Assists Corporate Insurance Department with the Due Diligence process and works with Physician Enterprise to assure appropriate documentation is received and reviewed
  • Notifies insurance broker of terminations/resignations of healthcare providers
  • Investigates all incidents related to vehicle and property claims in conjunction with insurance manager
  • Receives and investigates recall reports of medical device and product problems in collaboration with the Purchasing Dept
  • Represents the Enterprise Risk Management Department on various medical center committees as assigned
  • Participates in training of team members and in-services provided by the Enterprise Risk Management team
  • Adheres to HMH Organizational competencies and standards of behavior
  • Must work independently with general guidance on a wide variety of special projects
  • All other duties and projects as assigned to assist the Enterprise Risk Management Department to maintain daily activities of the departments.

Qualifications
Education, Knowledge, Skills and Abilities Required:
  • Minimum of Associates degree in Business, Insurance or related field or at least 5 years of related work experience in Risk, Paralegal, Insurance, or other related field
  • Proficient in Google Suite
  • Strong analytical and communication skills
  • Knowledge of legal and medical terminology
  • Excellent technological skills and organizational skills

Education, Knowledge, Skills and Abilities Preferred:
  • A minimum of 1 to 3 years of experience in risk management, claims, and/or insurance experience is preferred.
  • Experience working with Insurance Brokers and representatives preferred.

If you feel that the above description speaks directly to your strengths and capabilities, then please apply today!
Starting Minimum Rate
Minimum rate of $56,430.40 Annually
Job Posting Disclosure
HMH is committed to pay equity and transparency for our team members. The posted rate of pay in this job posting is a reasonable good faith estimate of the minimum base pay for this role at the time of posting in accordance with the New Jersey Pay Transparency Act and does not reflect the full value of our market-competitive total rewards package.
The starting rate of pay is provided for informational purposes only and is not a guarantee of a specific offer. Posted hourly rates may be stated as an annual salary in the offer and posted annual salaries may be stated as an hourly rate in the offer, depending on the level and nature of the job duties and credentials of the candidate. The base compensation determined at the time of the offer may be different than the posted rate of pay based on a number of non-discriminatory factors, including but not limited to:
Labor Market Data: Compensation is benchmarked against market data to ensure competitiveness.
Experience: Years of relevant work experience.
Education and Certifications: Level of education attained, including specialized certifications, credentials, completed apprenticeship programs or advanced training.
Skills: Demonstrated proficiency in relevant skills and competencies.
Geographic Location: Cost of living and market rates for the specific location.
Internal Equity: Compensation is determined in a manner consistent with compensation ranges for similar roles within the organization.
Budget and Grant Funding: Departmental budgets and any grant funding associated with the job position may impact the pay that can be offered.
Some jobs may also be eligible for performance-based incentives, bonuses, or commissions not reflected in the starting rate. Certain positions may also be eligible for shift differentials for work performed on evening, night, or weekend shifts.
In addition to our compensation for full-time and part-time (20+ hours/week) job positions, HMH offers a comprehensive benefits package, including health, dental, vision, paid leave, tuition reimbursement, and retirement benefits.

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