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
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
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 ...
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 ...
Insurance Adjuster
San Juan, PR · On-site
Knowledge in the management of computer systems and keyboarding. * Experience handling claims and ... Valid Insurance Adjuster License issued by the Insurance Commissioner of Puerto Rico. * Mastery of ...
Quick apply
Insurance Adjuster
San Juan, PR · On-site
Knowledge in the management of computer systems and keyboarding. * Experience handling claims and ... Valid Insurance Adjuster License issued by the Insurance Commissioner of Puerto Rico. * Mastery of ...
Insurance billing practices * Coding experience * Managed care experience * Claims processing experience * Medical record familiarity * Experience in healthcare claims investigations * Experience in ...
Insurance billing practices * Coding experience * Managed care experience * Claims processing experience * Medical record familiarity * Experience in healthcare claims investigations * Experience in ...
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 ...
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 ...
HR Admin Support
$11 - $13/hr
Manage reporting and correspondence with state and government agencies, including but not limited to: * Unemployment insurance claims and inquiries * State disability and paid leave claims * New hire ...
HR Admin Support
$11 - $13/hr
Manage reporting and correspondence with state and government agencies, including but not limited to: * Unemployment insurance claims and inquiries * State disability and paid leave claims * New hire ...
HR Admin Support
San Juan, PR · On-site
$11 - $13/hr
Manage reporting and correspondence with state and government agencies, including but not limited to: * Unemployment insurance claims and inquiries * State disability and paid leave claims * New hire ...
HR Admin Support
San Juan, PR · On-site
$11 - $13/hr
Manage reporting and correspondence with state and government agencies, including but not limited to: * Unemployment insurance claims and inquiries * State disability and paid leave claims * New hire ...
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
Claims Examiner
Guaynabo, PR · On-site
$21/hr
Medicare, Medicaid, commercial insurance, or managed care ; Clinical documentation review Proficiency with: ICD-10-CM ; CPT ; HCPCS ; Medical terminology ; Anatomy and physiology ; EHR systems (such ...
Claims Examiner
Guaynabo, PR · On-site
$21/hr
Medicare, Medicaid, commercial insurance, or managed care ; Clinical documentation review Proficiency with: ICD-10-CM ; CPT ; HCPCS ; Medical terminology ; Anatomy and physiology ; EHR systems (such ...
PR · On-site
$19/hr
... Insurance (SSDI) and Supplemental Security Income (SSI) claims process. Our mission is to provide ... This role is responsible for managing disability claims from intake through resolution, ensuring ...
Quick apply
PR · On-site
$19/hr
... Insurance (SSDI) and Supplemental Security Income (SSI) claims process. Our mission is to provide ... This role is responsible for managing disability claims from intake through resolution, ensuring ...
... insurance, claims, and risk indicators, ensuring data accuracy and actionable insights. Requirements Education: Bachelor's degree in Business Administration, Finance, Accounting, Risk Management ...
... insurance, claims, and risk indicators, ensuring data accuracy and actionable insights. Requirements Education: Bachelor's degree in Business Administration, Finance, Accounting, Risk Management ...
Investigate incidents and prepare required reports, including injury reports, insurance claims ... Support workers' compensation administration. * Assist with waste management programs, manifests ...
Investigate incidents and prepare required reports, including injury reports, insurance claims ... Support workers' compensation administration. * Assist with waste management programs, manifests ...
... insurance claims, performance metric reports, etc. * Take necessary steps to ensure a safe work ... Alerts management when problems are identified and make recommendations for improvements. * Must be ...
... insurance claims, performance metric reports, etc. * Take necessary steps to ensure a safe work ... Alerts management when problems are identified and make recommendations for improvements. * Must be ...
PR · On-site
... insurance claims, performance metric reports, etc. * Take necessary steps to ensure a safe work ... Alerts management when problems are identified and make recommendations for improvements. * Must be ...
Quick apply
PR · On-site
... insurance claims, performance metric reports, etc. * Take necessary steps to ensure a safe work ... Alerts management when problems are identified and make recommendations for improvements. * Must be ...
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?
| Aspect | Insurance Claims Manager | Insurance Adjuster |
|---|---|---|
| Credentials | Typically requires a bachelor’s degree; certifications like CPCU or AIC are common | High school diploma or bachelor’s; certifications like AIC or state licensing often needed |
| Work Environment | Office-based, managing teams and claims processes | Field or office-based, investigating claims and assessing damages |
| Employer & Industry | Insurance companies, claims departments | Insurance companies, independent adjusting firms |
| Primary Focus | Overseeing claims processes, managing staff, ensuring policy compliance | Evaluating 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:
Full-time
Posted 10 days ago
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
EDUCATION
EXPERIENCE
LICENSES AND CERTIFICATIONS
COMPETENCIES
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.
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.