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Claims Risk Manager Jobs in Minnesota (NOW HIRING)

LTCG

Claims Manager - LSW or RN

Eden Prairie, MN · Hybrid

We also provide clients with unique risk management insight built upon our proprietary long term care databases. The Claims Manager position is responsible for evaluation and rendering eligibility ...

Corvel

Indemnity Claims Specialist

Minneapolis, MN · Remote

$51K - $83K/yr

The Indemnity Claims Specialist manages within company best practices lower-level, non-complex and ... CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for ...

Corvel

Indemnity Claims Specialist

Minneapolis, MN · On-site

$51K - $83K/yr

The Indemnity Claims Specialist manages within company best practices lower-level, non-complex and ... CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for ...

Corvel

Senior Indemnity Claims Specialist

Minneapolis, MN · Remote

$59K - $96K/yr

The Senior Claims Indemnity Specialist handles complex and high-profile Workers' Compensation ... CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for ...

LTCG

Claims Intake- Long Term Care

Eden Prairie, MN

We also provide clients with unique risk management insight built upon our proprietary databases ... claims This position assists Care Managers and Care Coordinators, while also providing quality ...

LTCG

Claims Intake- Long Term Care

Eden Prairie, MN

We also provide clients with unique risk management insight built upon our proprietary databases ... claims This position assists Care Managers and Care Coordinators, while also providing quality ...

illumifin

Claims Intake- Long Term Care

Eden Prairie, MN · On-site +1

$18.50/hr

We also provide clients with unique risk management insight built upon our proprietary databases ... continuation claims. This position assists Care Managers and Care Coordinators, while also ...

Berkley

WC Claims Representative 1

Minneapolis, MN · On-site

$50K - $62K/yr

Berkley Risk is focused on providing self-insured entities program administration services and ... Manage caseload with assistance of computer-operated diary and maintain current diaries.

Berkley

WC Claims Representative 1

Minneapolis, MN · On-site

$50K - $62K/yr

Berkley Risk is focused on providing self-insured entities program administration services and ... Manage caseload with assistance of computer-operated diary and maintain current diaries.

Berkley

WC Claims Representative 1

Minneapolis, MN · On-site

$50K - $62K/yr

Berkley Risk is focused on providing self-insured entities program administration services and ... Manage caseload with assistance of computer-operated diary and maintain current diaries.

Berkley

WC Claims Associate

Saint Paul, MN · On-site

$50K - $62K/yr

Berkley Risk is a member company of W. R. Berkley Corporation, an A. M. Best A+ rated Fortune 500 ... Work experience should demonstrate organizational skills, time management skills, multi-tasking ...

Berkley

WC Claims Associate

Saint Paul, MN · On-site

$50K - $62K/yr

Company Details Berkley Risk is a member company of W. R. Berkley Corporation, an A. M. Best A ... Work experience should demonstrate organizational skills, time management skills, multi-tasking ...

Berkley

WC Claims Associate

Saint Paul, MN · On-site

$50K - $62K/yr

Company Details Berkley Risk is a member company of W. R. Berkley Corporation, an A. M. Best A ... Work experience should demonstrate organizational skills, time management skills, multi-tasking ...

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Claims Risk Manager information

How does a Claims Risk Manager typically collaborate with other departments to minimize organizational risk?

A Claims Risk Manager works closely with departments such as underwriting, legal, compliance, and operations to identify potential risk exposures and implement effective mitigation strategies. They often participate in cross-functional meetings to review claims trends, share insights, and develop risk management policies. This collaborative approach ensures that the organization proactively addresses risks, maintains regulatory compliance, and continually improves claims processes for better outcomes.

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

AspectClaims Risk ManagerClaims Adjuster
CredentialsTypically requires a bachelor’s degree in risk management, insurance, or related field; certifications like CPCU or ARM are commonRequires a high school diploma or bachelor’s degree; insurance licenses may be needed depending on state
Work EnvironmentOffice-based, strategic planning, risk assessment, policy developmentField or office-based, investigating claims, assessing damages, negotiating settlements
Industry UsageUsed across insurance companies, risk management firms, and large corporationsPrimarily in insurance companies, adjusting claims for auto, property, or health insurance

The Claims Risk Manager focuses on identifying and mitigating risks related to claims, developing policies, and overseeing risk strategies. In contrast, a Claims Adjuster handles the day-to-day investigation and settlement of individual claims. Both roles are essential in the insurance industry but differ in scope and responsibilities.

What are the key skills and qualifications needed to thrive as a Claims Risk Manager, and why are they important?

To thrive as a Claims Risk Manager, you need expertise in insurance claims processes, risk assessment, and regulatory compliance, typically backed by a bachelor’s degree in a relevant field and experience in claims management. Familiarity with claims management systems, risk modeling software, and certifications such as CPCU (Chartered Property Casualty Underwriter) or ARM (Associate in Risk Management) are often required. Strong analytical thinking, attention to detail, and effective communication skills help you investigate claims and collaborate with stakeholders. These skills enable accurate risk evaluation, minimize losses, and ensure the organization’s compliance and financial stability.

What does a Claims Risk Manager do?

A Claims Risk Manager is responsible for identifying, assessing, and managing risks associated with insurance claims within an organization. They analyze claims data to detect patterns, prevent fraudulent activity, and develop strategies to minimize financial losses. Additionally, they work closely with claims adjusters, legal teams, and other departments to ensure compliance with regulations and to optimize claims processes. Their goal is to protect the company from unnecessary losses while ensuring legitimate claims are handled efficiently.
What are popular job titles related to Claims Risk Manager jobs in Minnesota? For Claims Risk Manager jobs in Minnesota, the most frequently searched job titles are:
What job categories do people searching Claims Risk Manager jobs in Minnesota look for? The top searched job categories for Claims Risk Manager jobs in Minnesota are:
What cities in Minnesota are hiring for Claims Risk Manager jobs? Cities in Minnesota with the most Claims Risk Manager job openings:
Claims Risk Manager jobs near you

Claims Manager - LSW or RN

LTCG

Eden Prairie, MN • Hybrid

Full-time

Posted 8 days ago

Key responsibilities

  • Review internal databases, client guidelines and policy contract language to evaluate home and facility-based claims in accordance with department processes and standards.

  • Communicate with claimants, representatives, third parties, physicians and healthcare providers via written letters and phone calls as required by agreed upon SLAs.

  • Create plans of care and complete Chronic Illness Certification as appropriate.

Job description

The nation's leading administrator of long term care insurance services is looking for YOU. This is your opportunity to join a company with a culture that promotes respect for people, integrity, learning and initiative.
WE ARE THE KIND OF EMPLOYER YOU DESERVE.
illumifin is a leading provider of business process outsourcing for the insurance industry, managing over 1.3 million long-term care policies for the nation's largest insurers. We also provide clients with unique risk management insight built upon our proprietary long term care databases.
The Claims Manager position is responsible for evaluation and rendering eligibility decisions on home and facility based Long Term Care claims (standalone and hybrid), chronic illness riders and/or critical illness within client contract and policy parameters, while providing quality customer service to our policy holders, their representatives and providers. A Claims Manager will be required to review and certify for chronic illness.
CLAIMS MANAGER RESPONSIBILITIES
  • Review internal databases, client guidelines and policy contract language to evaluate routine home and facility-based claims, in accordance with department processes and standards.
  • Communicate clearly and routinely with claimants, representatives, third parties, physicians and healthcare providers via written letters and phone calls as required by agreed upon SLAs and. Additionally, effectively communicate with team members and leadership on cases, as needed.
  • Query service providers to obtain licensure information, proof of loss and dates of service. Verify that provider and/or care is appropriate base on the claimant's diagnosis and is in accordance with contract language and government regulations regarding healthcare providers.
  • Maintain clear and concise documentation of all claim activity within the required databases.
  • Create plans of care and complete Chronic Illness Certification as appropriate.
  • Provide prompt, courteous and excellent customer service to internal and external customers.
  • Demonstrate effective communication skills, level of attentiveness and use of appropriate lines of authority. Promptly share accurate and complete information to others who need it, based on HIPAA and legal documents regarding release.
  • Perform work accurately and demonstrate ability to prioritize workload.
  • Participate in team meetings and assist colleagues with their work loads when appropriate.
  • Uphold the principles of compliance as outlined in the Code of Conduct, Employee Handbook and related policies and procedures. Supports and participates in the mandatory Corporate Compliance Program training initiative on an annual or more frequent basis, as required.
  • Meet established quality and production expectations as established and communicated by the department.
  • Work independently with minimal direction.
  • Other duties as assigned.

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