... risk and improve operational performance. The analyst collaborates with Claims Operations, Provider ... Management, or a related field preferred Experience * Three (3) or more years of experience in ...
... risk and improve operational performance. The analyst collaborates with Claims Operations, Provider ... Management, or a related field preferred Experience * Three (3) or more years of experience in ...
Proactively manages assigned claims caseload comprised of complex damages that require commensurate ... risk and compliance policies and procedures. What you have: * High School Diploma or General ...
Proactively manages assigned claims caseload comprised of complex damages that require commensurate ... risk and compliance policies and procedures. What you have: * High School Diploma or General ...
Proactively manages assigned claims caseload comprised of complex damages that require commensurate ... risk and compliance policies and procedures. What you have: * High School Diploma or General ...
Proactively manages assigned claims caseload comprised of complex damages that require commensurate ... risk and compliance policies and procedures. What you have: * High School Diploma or General ...
Proactively manages assigned claims caseload comprised of complex damages that require commensurate ... risk and compliance policies and procedures. What you have: * High School Diploma or General ...
Proactively manages assigned claims caseload comprised of complex damages that require commensurate ... risk and compliance policies and procedures. What you have: * High School Diploma or General ...
Eligibility Manager
Fresno, CA · On-site
$45K - $59K/yr
... risk. The Eligibility Manager provides strategic direction, leadership, and supervision to the ... This role requires close collaboration with multiple departments (Claims, Intake, Social Work, and ...
Eligibility Manager
Fresno, CA · On-site
$45K - $59K/yr
... risk. The Eligibility Manager provides strategic direction, leadership, and supervision to the ... This role requires close collaboration with multiple departments (Claims, Intake, Social Work, and ...
Manager, R&D - Specialized Tax & Incentives Group
Fresno, CA · On-site
$116K - $152K/yr
Oversee the preparation of technical reports and supporting documentation for tax credit claims ... Ensures firm risk management and tax quality control standards and protocols are met * Communicates ...
Manager, R&D - Specialized Tax & Incentives Group
Fresno, CA · On-site
$116K - $152K/yr
Oversee the preparation of technical reports and supporting documentation for tax credit claims ... Ensures firm risk management and tax quality control standards and protocols are met * Communicates ...
Associate Director
Fresno, CA · On-site
Monitor workers' compensation claims, restrictions, and return-to-work coordination in ... in California property management, portfolio administration, compliance, or risk-related ...
Quick apply
Associate Director
Fresno, CA · On-site
Monitor workers' compensation claims, restrictions, and return-to-work coordination in ... in California property management, portfolio administration, compliance, or risk-related ...
Regulatory Compliance & Risk Management * Ensure compliance with global regulatory bodies including ... Effective claims management from start to finish including reporting, documentation, investigations ...
Regulatory Compliance & Risk Management * Ensure compliance with global regulatory bodies including ... Effective claims management from start to finish including reporting, documentation, investigations ...
Regulatory Compliance & Risk Management * Ensure compliance with global regulatory bodies including ... Effective claims management from start to finish including reporting, documentation, investigations ...
Regulatory Compliance & Risk Management * Ensure compliance with global regulatory bodies including ... Effective claims management from start to finish including reporting, documentation, investigations ...
... risk exposure. The scope, autonomy, and complexity of responsibilities increase by level , ranging ... Manages full customer service lifecycle (billing, claims, coverage) * Leads renewal strategy ...
... risk exposure. The scope, autonomy, and complexity of responsibilities increase by level , ranging ... Manages full customer service lifecycle (billing, claims, coverage) * Leads renewal strategy ...
... risk exposure. The scope, autonomy, and complexity of responsibilities increase by level , ranging ... Manages full customer service lifecycle (billing, claims, coverage) * Leads renewal strategy ...
... risk exposure. The scope, autonomy, and complexity of responsibilities increase by level , ranging ... Manages full customer service lifecycle (billing, claims, coverage) * Leads renewal strategy ...
Assistant Account Representative -Agriculture P&C Insurance
Fresno, CA · On-site
$23 - $25/hr
Alliant is changing the way our clients approach risk management and benefits, so they can ... Processes and tracks claims; Inputs applications and word processes letters, and other forms of ...
Assistant Account Representative -Agriculture P&C Insurance
Fresno, CA · On-site
$23 - $25/hr
Alliant is changing the way our clients approach risk management and benefits, so they can ... Processes and tracks claims; Inputs applications and word processes letters, and other forms of ...
Part D Administrator
Fresno, CA · On-site
... benefit managers (PBMs), pharmacies, and long-term care facilities. * Oversee PBM claims ... Track participant drug utilization, identify high-risk or high-cost medications, and implement ...
Part D Administrator
Fresno, CA · On-site
... benefit managers (PBMs), pharmacies, and long-term care facilities. * Oversee PBM claims ... Track participant drug utilization, identify high-risk or high-cost medications, and implement ...
... Management oversees the business and administrative operations of a medical practice. Financial ... claims. * Escalate high-risk accounts to leadership or appropriate teams for review. Denials ...
... Management oversees the business and administrative operations of a medical practice. Financial ... claims. * Escalate high-risk accounts to leadership or appropriate teams for review. Denials ...
... Management oversees the business and administrative operations of a medical practice. Financial ... claims. * Escalate high-risk accounts to leadership or appropriate teams for review. Denials ...
... Management oversees the business and administrative operations of a medical practice. Financial ... claims. * Escalate high-risk accounts to leadership or appropriate teams for review. Denials ...
Coordinator, Financial Counseling
$21 - $27.72/hr
... Management oversees the business and administrative operations of a medical practice. Financial ... claims. Escalate high-risk accounts to leadership or appropriate teams for review. Denials ...
Coordinator, Financial Counseling
$21 - $27.72/hr
... Management oversees the business and administrative operations of a medical practice. Financial ... claims. Escalate high-risk accounts to leadership or appropriate teams for review. Denials ...
Coordinator, Financial Counseling
Fresno, CA · On-site
$21 - $27.72/hr
... Management oversees the business and administrative operations of a medical practice. Financial ... claims. * Escalate high-risk accounts to leadership orappropriate teamsfor review. Denials ...
Coordinator, Financial Counseling
Fresno, CA · On-site
$21 - $27.72/hr
... Management oversees the business and administrative operations of a medical practice. Financial ... claims. * Escalate high-risk accounts to leadership orappropriate teamsfor review. Denials ...
Coordinator, Financial Counseling
Fresno, CA · On-site
$21 - $27.72/hr
... Management oversees the business and administrative operations of a medical practice. Financial ... claims. * Escalate high-risk accounts to leadership orappropriate teamsfor review. Denials ...
Coordinator, Financial Counseling
Fresno, CA · On-site
$21 - $27.72/hr
... Management oversees the business and administrative operations of a medical practice. Financial ... claims. * Escalate high-risk accounts to leadership orappropriate teamsfor review. Denials ...
Employment Law Senior Attorney - PAGA
Fresno, CA · On-site
$230K - $300K/yr
... risk and prevent PAGA claims. * Monitor legal developments and provide strategic guidance on ... Commitment to proactive case management. Health & Wellness * Medical plan options including Kaiser ...
Quick apply
Employment Law Senior Attorney - PAGA
Fresno, CA · On-site
$230K - $300K/yr
... risk and prevent PAGA claims. * Monitor legal developments and provide strategic guidance on ... Commitment to proactive case management. Health & Wellness * Medical plan options including Kaiser ...
Sr. Auditor, Health Plan
Fresno, CA · On-site +1
$46.52 - $59.20/hr
... and reduce risk to the strategies and objectives of Community Care Health (CCH). Designs and ... Bachelor's Degree in Accounting, Business, Management, Finance, Healthcare Administration ...
Quick apply
Sr. Auditor, Health Plan
Fresno, CA · On-site +1
$46.52 - $59.20/hr
... and reduce risk to the strategies and objectives of Community Care Health (CCH). Designs and ... Bachelor's Degree in Accounting, Business, Management, Finance, Healthcare Administration ...
Claims Risk Manager information
See Fresno, CA salary details
$34.8K - $44.1K
4% of jobs
$44.1K - $53.5K
4% of jobs
$53.5K - $62.9K
10% of jobs
$66.5K is the 25th percentile. Wages below this are outliers.
$62.9K - $72.3K
18% of jobs
$72.3K - $81.7K
12% of jobs
The median wage is $83.3K / yr.
$81.7K - $91.1K
13% of jobs
$91.1K - $100.5K
14% of jobs
$100.9K is the 75th percentile. Wages above this are outliers.
$100.5K - $109.9K
12% of jobs
$109.9K - $119.2K
7% of jobs
$119.2K - $128.6K
4% of jobs
$128.6K - $138K
2% of jobs
$34.8K
$87.2K
$138K
How much do claims risk manager jobs pay per year?
As of Sep 2, 2026, the average yearly pay for claims risk manager in Fresno, CA is $87,238.00, according to ZipRecruiter salary data. Most workers in this role earn between $67,500.00 and $104,300.00 per year, depending on experience, location, and employer.
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 the key skills and qualifications needed to thrive as a claims risk manager?
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.
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?
| Aspect | Claims Risk Manager | Claims Adjuster |
|---|---|---|
| Credentials | Typically requires a bachelor’s degree in risk management, insurance, or related field; certifications like CPCU or ARM are common | Requires a high school diploma or bachelor’s degree; insurance licenses may be needed depending on state |
| Work Environment | Office-based, strategic planning, risk assessment, policy development | Field or office-based, investigating claims, assessing damages, negotiating settlements |
| Industry Usage | Used across insurance companies, risk management firms, and large corporations | Primarily 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.
How much do claims risk managers make in the US?
Claims risk managers in the US typically earn a median annual salary of around $80,000 to $100,000, with experienced professionals and those in senior roles earning over $120,000. Salaries vary based on location, industry, experience, and certifications such as CPCU or ARM.
Is Claims Risk Manager a good career?
A Claims Risk Manager oversees the assessment and mitigation of insurance claim risks, often requiring strong analytical skills and knowledge of insurance policies. The role offers opportunities for advancement and typically involves working in insurance, risk management, or corporate environments. It can be a stable and rewarding career for those interested in risk analysis and insurance processes.
What are popular job titles related to Claims Risk Manager jobs in Fresno, CA?
For Claims Risk Manager jobs in Fresno, CA, the most frequently searched job titles are:
What job categories do people searching Claims Risk Manager jobs in Fresno, CA look for?
The top searched job categories for Claims Risk Manager jobs in Fresno, CA are:
What cities near Fresno, CA are hiring for Claims Risk Manager jobs?
Cities near Fresno, CA with the most Claims Risk Manager job openings:
Full-time
Medical, Retirement, PTO
This job post has expired 1 day ago. Applications are no longer accepted.
Job description
Overview
Opportunities for you!
- Consecutively recognized as a top employer by Forbes, and in 2025 by Newsweek
- Free Continuing Education and certification
- Tuition reimbursement, education programs and scholarships
- Vacation time starts building on Day 1, and builds with your seniority
- Free money toward retirement with a 403(b) and matching contributions
- Great food options with on-demand ordering
- Free parking and electric charging
Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community.
We know that our ability to provide the highest level of care is through taking care of our incredible teams. Learn more on our Benefits page.
ResponsibilitiesThe Cost-Containment Analyst is responsible for identifying, investigating, and resolving post-payment and pre-payment claim recovery opportunities while ensuring accurate claims administration and compliance with health plan policies, provider contracts, and applicable regulations. This position performs complex claim adjustments, manages provider payment disputes, processes claim payment refunds, coordinates subrogation and recovery activities, and analyzes claim payment trends to minimize financial risk and improve operational performance. The analyst collaborates with Claims Operations, Provider Relations, Finance, Legal, Compliance, and external stakeholders to ensure timely resolution of payment discrepancies and maximize cost recovery for the health plan. QualificationsEducation- High School Diploma, High School Equivalency (HSE), or Completion of a CHS Approved Individualized Education Plan (IEP) Certificate required
- Associate's or Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, Health Information Management, or a related field preferred
- Three (3) or more years of experience in health plan claims, payment integrity, cost containment, provider disputes, recovery, subrogation, or claims auditing, required
- Experience with provider contract interpretation and reimbursement analysis required
- Experience with health plan claims systems, particularly QNXT, preferred
- Advanced Microsoft Excel skills and experience with reporting or business intelligence tools are preferred
Pay ranges listed are an estimate and subject to change. If any bonuses are noted, they are only applicable to external hires meeting criteria.
Employment Type: OTHER
About Community Health System
Sourced by ZipRecruiter
Industry
Hospitals
Company size
5,001 - 10,000 Employees
Headquarters location
CA, US