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Insurance Claims Manager Jobs in Puerto Rico (NOW HIRING)

Grupo Triple-S

Casualty Manager

Guaynabo, PR · On-site

Is responsible for managing high-risk claims, ensuring compliance with company policies and ... Puerto Rico All Lines Insurance Adjuster License. LICENSES AND CERTIFICATIONS COMPETENCIES

Grupo Triple-S

Claims Supervisor

Guaynabo, PR · On-site

... insurance industry analysis, investigation, auditing and/or risk management in a Healthcare setting. LICENSES AND CERTIFICATIONS * None required COMPETENCIES * Financial & Business Acumen * Data ...

Deloitte

Epic Denials Management Operator

San Juan, PR · Remote

$17.75 - $23.50/hr

Rebill corrected claims and route issues to coding, billing, credentialing, denials, and/or ... Ability to manage and prioritize multiple tasks in a fast-paced and dynamic environment * Strong ...

Assurant, Inc

Sr. Auto Claims Analyst

San Juan, PR

Bachelor's degree, preferably in Engineering, Business Administration, Finance, Accounting, Risk Management or Insurance. * 5+ years of experience in auto claims, extended warranties, or vehicle ...

Deloitte

Epic Denials Manager

San Juan, PR · Remote

Oversight and management of claims and denials management follow-up operations. Analyzes, plans and ... insurance regulations, managed care contracts billing regulations, coding and fee schedules.

Walgreens

Pharmacy Manager

Carolina, PR · On-site

$56.45 - $69/hr

Ensures insurance claims are processed accurately to prevent payment rejections. Resolves patient ... Manages the maintenance, housekeeping, and improvement of the pharmacy department including repairs ...

Walgreens

Pharmacy Operations Manager

Carolina, PR · On-site

Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment ... Manages Community Outreach Portal and coordinates and, at the direction of the Pharmacy Manager ...

Walgreens

Pharmacy Operations Manager

Dorado, PR · On-site

Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment ... Manages Community Outreach Portal and coordinates and, at the direction of the Pharmacy Manager ...

Walgreens

Pharmacy Operations Manager

Carolina, PR · On-site

Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment ... Manages Community Outreach Portal and coordinates and, at the direction of the Pharmacy Manager ...

Walgreens

Pharmacy Operations Manager

Carolina, PR · On-site

Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment ... Manages Community Outreach Portal and coordinates and, at the direction of the Pharmacy Manager ...

Walgreens

PR · On-site

Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment ... Manages Community Outreach Portal and coordinates and, at the direction of the Pharmacy Manager ...

Walgreens

Pharmacy Operations Manager

Guaynabo, PR · On-site

Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment ... Manages Community Outreach Portal and coordinates and, at the direction of the Pharmacy Manager ...

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Insurance Claims Manager information

What does an insurance claims manager do?

An Insurance Claims Manager oversees the processing of insurance claims to ensure they are handled efficiently, fairly, and in compliance with company and legal standards. They manage a team of claims adjusters and analysts, review complex or disputed claims, and develop strategies to improve claims procedures. Their role also involves liaising with policyholders, third parties, and legal professionals to resolve issues and minimize fraud or errors. Effective Claims Managers balance customer service with cost control to protect both the insurer and the policyholder.

What are the key skills and qualifications needed to thrive as an insurance claims manager?

To thrive as an Insurance Claims Manager, you need a solid understanding of insurance policies, claims processes, and risk assessment, typically supported by a bachelor's degree in finance, business, or a related field. Familiarity with claims management software (such as Guidewire or ClaimCenter) and certifications like Associate in Claims (AIC) are commonly required. Excellent leadership, negotiation, and problem-solving skills set top performers apart in this role. These abilities are crucial for efficiently managing claims teams, reducing fraud, and ensuring timely, fair settlements for clients.

What are some common challenges faced by insurance claims managers, and how can they be addressed?

Insurance Claims Managers often encounter challenges such as managing complex claims, addressing customer dissatisfaction, and staying up-to-date with regulatory changes. To overcome these, successful managers prioritize clear communication, maintain strong organizational systems, and foster collaboration between adjusters, underwriters, and legal teams. Proactively investing in ongoing training and leveraging technology for claims processing also helps streamline workflows and improve customer experiences.

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

AspectInsurance Claims ManagerInsurance Adjuster
CredentialsTypically requires a bachelor’s degree; certifications like CPCU or AIC are commonHigh school diploma or bachelor’s; certifications like AIC or state licensing often needed
Work EnvironmentOffice-based, managing teams and claims processesField or office-based, investigating claims and assessing damages
Employer & IndustryInsurance companies, claims departmentsInsurance companies, independent adjusting firms
Primary FocusOverseeing claims processes, managing staff, ensuring policy complianceEvaluating damages, determining claim validity, negotiating settlements

While both roles are integral to the insurance claims process, the Insurance Claims Manager oversees the entire claims operation and manages staff, whereas the Insurance Adjuster focuses on investigating individual claims and assessing damages. The roles often work together but differ in scope and responsibilities.

What are the most commonly searched types of Insurance Claims jobs in Puerto Rico?

The most popular types of Insurance Claims jobs in Puerto Rico are:

What are popular job titles related to Insurance Claims Manager jobs in Puerto Rico?

For Insurance Claims Manager jobs in Puerto Rico, the most frequently searched job titles are:

What job categories do people searching Insurance Claims Manager jobs in Puerto Rico look for?

The top searched job categories for Insurance Claims Manager jobs in Puerto Rico are:

Insurance Claims Manager jobs near you
Infographic showing various Insurance Claims Manager job openings in Puerto Rico as of August 2026, with employment types broken down into 1% As Needed, 73% Full Time, 20% Part Time, 2% Temporary, and 4% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution.

Casualty Manager

Grupo Triple-S

Guaynabo, PR • On-site

Full-time

Re-posted yesterday

Job description

Casualty Manager
Company: Triple-S Propiedad
Job Location (Short): Guaynabo, PR
Posting Start Date: 8/3/26
At Triple-S, we are committed to providing meaningful job experiences for Valuable People (Gente Valiosa). We strive for excellence in everything we do, from the way we work together to the way we serve our customers.
When you join Triple-S, you will be key to our efforts on delivering high-quality and affordable healthcare as well as contribute to our purpose to enable healthier lives. We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid, Commercial, Life and Property & Casualty Businesses.
Let's build healthier communities together, join now!
JOB SUMMARY
In charge of leading our casualty claims management efforts, overseeing all aspects of claims handling, from investigation to resolution. Is responsible for managing high-risk claims, ensuring compliance with company policies and procedures, and supervising internal and external personnel. As a key member of our claims leadership team, the Casualty Claims Manager will collaborate with internal stakeholders, including the Legal Manager, to drive tactical plans and make strategic decisions that minimize reputational risk and financial exposure. Provides strategic direction to drive tactical plans of the company, in addition to administrative responsibilities and development of its employees.
ESSENTIAL FUNCTIONS
  • Supervise and manage legal and non-legal adjusters in the casualty/legal claims area.
  • Supervise coverage analysis for all litigated claims and coordinating support for coverage analysis in non-litigated claims.
  • Oversee effective investigations of claims, ensuring thorough, accurate and timely reports.
  • Manage delegated monetary authority for claims resolution.
  • Collaborate with the Legal Manager to develop and implement litigation strategies, including adjustments, expert resources, and budgeting.
  • Approve determination of appeal resources, in collaboration with the Legal Manager.
  • Oversee approval of billing generated by vendors in claims.
  • Manage adequacy of indemnity reserves for casualty/legal claims.
  • Administer reporting to reinsurers on claims as required.

EDUCATION
  • Bachelor's Degree

EXPERIENCE
  • Bachelor's degree from an accredited institution with 10 years of experience in Claims adjustment, vast and extensive knowledge of Property and Casualty Policies and Regulations.
  • Puerto Rico All Lines Insurance Adjuster License.

LICENSES AND CERTIFICATIONS
COMPETENCIES
  • Customer Delight
  • Data Driven Insights
  • Develops Talent
  • Financial & Business Acumen
  • One Company Mindset
  • Practical Knowledge in Tech

It is company policy to seek for the qualified applicants for positions throughout the company without distinction of race, color, national origin, religion, sex, gender identity, real or perceived sexual orientation, civil status, social condition, political ideologies, age, physical or mental disability, veteran status or any other characteristic protected by law. Drug-free company.
Equality Employment Opportunity/Affirmative Action for People with Disabilities/Veterans. Employer with E-Verify to verify the eligibility of employment of all the new employees.
We encourage Veterans and Disabled to Apply.

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