1

Insurance Claims Manager Jobs in Puerto Rico (NOW HIRING)

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 ...

One (1) to three (3) years of experience in health insurance operations, provider relations, claims administration, and/or managed care environment. LICENSES AND CERTIFICATIONS * None required ...

Examine insurance proposals, gather and evaluate background information in order to effectively ... top management. * Assist Operations Department in policy issuance as well as support Claims ...

Multi-Line Adjuster - Inside

Guaynabo, PR · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Minimum 2 years insurance adjusting experience with experience in each of at least two lines of ... Negotiates and settles claims, sets reserves, and manages litigation within client service ...

PR · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Revenue Cycle Management Specialist I Who are we? For more than 26 years, CorePlus has provided ... Responsibilities 1. Accurately code and submit claims to insurance companies and government payers ...

PR · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Revenue Cycle Management Specialist I Who are we? For more than 26 years, CorePlus has provided ... Responsibilities 1. Accurately code and submit claims to insurance companies and government payers ...

PR · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

6 Months Assignment - Revenue Cycle Management Specialist Who are we? For more than 30 years ... Responsibilities 1. Accurately code and submit claims to insurance companies and government payers ...

Attorney

San Juan, PR · On-site

$60K - $80K/yr

  • Medical

  • Retirement

  • PTO

... with insurance companies, and guiding clients through the pre-litigation process with ... Manage a caseload of personal injury claims from intake through settlement. * Evaluate cases for ...

Underwriter

San Juan, PR · On-site

$79K - $119K/yr

Description Liberty Specialty Markets (LSM) offers specialty and commercial insurance and ... Collaborate with internal stakeholders, including UW Support, Claims, Actuarial, and the GRS Global ...

PR · On-site

Properly enter test claims to verify business rules set up in the system. * Perform quality ... Support all Quality Management Program initiatives. * Perform other duties as assigned. TRAINING ...

PR · On-site

Properly enter test claims to verify business rules set up in the system. * Perform quality ... Works with the Benefit team, Account Management and Quality Internal Audits to evaluate complex ...

PR

$10.50 - $14/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... insurance benefits, provider contracts, eligibility and claims. * Analyzes problems and provides ... Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the ...

Cust Care Rep I-Bilingual (US)

San Juan, PR · On-site

$15.75 - $21.25/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... insurance benefits, provider contracts, eligibility and claims. * Analyzes problems and provides ... Non-Management Non-Exempt Workshift: Job Family: CUS > Care Reps Please be advised that Elevance ...

PR · On-site

... new policies and claims. * Promote complementary company offerings such as credit insurance ... Proven ability to manage high workloads, prioritize multiple tasks, and meet deadlines. * Excellent ...

Showing results 21-40

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:

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.

Other

Re-posted 15 days ago


Job description

Mentor Technical Group (MTG) provides a comprehensive portfolio of technical support and solutions for the FDA-regulated industry. As a world leader in life science engineering and technical solutions, MTG has the knowledge and experience to ensure compliance with pharmaceutical, biotechnology, and medical device safety and efficacy guidelines. With offices in Caguas, PR, Boston, MA & San Francisco, CA and we serve life sciences clients in six global markets: United States, Puerto Rico, Dominican Republic, Mexico, Germany, Canada, and South America.

Essential Functions:

  • Contribute to a safe and quality working environment through training, awareness, and compliance to company policy and Federal/State/Local regulations as well as ensuring that all required records are prepared and maintained properly.
  • Monitors relevant and applicable regulations and accepted best industry practices and recommend programs, systems and corrective action for application at assigned site and if applicable for enterprise wide consideration.

Responsibilities:

  • Ensure accountability, transparency, cross-functionally and effective communication within the EHS Department while ensuring that information is timely, clear and accurate.
  • Investigate and prepare required reports of EHS system performance including but not limited to investigation reports, injury reports, insurance claims, performance metric reports, etc.
  • Take necessary steps to ensure a safe work environment for all employees.
  • Participate in the investigation of incidents, near misses and property damage incidents.
  • Ensure follow-up is done to minimize future exposure and proper records/documents are maintained.
  • Conduct, coordinate and track various training to support company programs.
  • Conduct routine safety observations to ensure compliance with regulatory agencies, company environmental, health, and safety policies, procedures and practices.
  • Maintain internal and regulatory reporting including data collection and reporting including but not limited to air, storm water and surface water discharge.
  • Ensure the company meets all its legislative compliance obligations with OSHA, CAL/OSHA, EPA, AQMD, ADA, and fire codes.
  • Serve as primary contact for all regulatory agencies for inspections, permitting, reporting (air, water, waste).
  • Maintain compliance with permits, government regulations and other industry practices.
  • Keep abreast of any safety and environmental law or regulation changes that impact the client.
  • Participate in manufacturing meetings to discuss workplace safety and regulatory concerns and opportunities.
  • Actively role model all company and assigned client environmental, health and safety standards.
  • Establish and maintain effective relationships with Operations, Managers, Supervisors and employees.
  • Assist in the oversight of the Worker’s Compensation program.
  • Promote excellent relationship with MENTOR clients, encouraging an open dialog and trustful communication between both parties demonstrating a professional conduct at all times and proudly represent MTG at all levels and places.
  • Alerts management when problems are identified and make recommendations for improvements.
  • Must be a team player committed to developing and working in a quality environment.
  • Complies with MENTOR’s administrative requirements timely and consistently in areas such as: weekly reports, updating of CV’s, yearly updates of medical/training records, attendance to work, etc.
  • Other duties and participation on special projects as required or assigned by manager, upper management or by the client. Implement and maintain a management of change process (MOC) to ensure that business, operational and/or administrative changes that may create adverse effects on people, property or the environment are anticipated, evaluated and controlled early in the process for continual compliance with all applicable regulatory requirements and standards.
  • Ensure compliance of Waste Management Programs as Hazardous Waste, Non Hazardous Waste General Trash, Biohazard and Recycling.
  • Prepare Hazardous Waste Manifests Reports.
  • Ensure compliance and update the EHS programs documentation.
  • Prepare Regulatory Reports to the Governing Agencies: ADS Trimester Reports, Biennial Reports, Waste Report and Waste Monthly Data Gathering.
  • Coordinate and supervise all the activities perform of recycling Program.
  • Prepare all the Waste shipments report and documentation of different suppliers.
  • Ensure and verify that all the areas, manages waste are in compliance with client standards and with Regulatory Agencies.
  • Audit EHS Programs Inspections and Follow-up of correctives actions in the Inspection Action Plan.
  • Conduct inspections training.
  • Prepare monthly Inspection.
  • (e-tool software) related with ergonomic program.
  • Conduct ergonomic, lifting and carrying techniques training.
  • Maintain and file the Near Miss, Management of Change forms and nonconformance's report, Ergo Assessments.
  • Participate in Near Miss, Incident and Accident Investigations


Qualifications Requirements/Knowledge/Education/Skills:

  • AD, Engineering or Science
  • Bachelor’s Degree in Engineering, Industrial Hygiene or Social Science related field.

Physical Requirements and Working Environment:

  • While performing the duties of this job, the employee is regularly required to use hands to finger, handle, feel, or operate equipment, tools, or controls. The employee frequently is required to stand, walk, talk, or hear; sit; climb or balance, stoop, kneel, crouch or crawl; and smell. The employee may lift and/or move up to 25-35 pounds and occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, depth perception, and the ability to adjust focus.
  • He / she may frequently work inside weather conditions, near moving mechanical parts, exposed to wet and or humid conditions, and an odorous atmosphere, may be exposed to fumes and the risk of electrical shock, and occasionally work on ladders in high places, in small spaces, such as lift/metering stations, manholes, tanks and wet wells. The noise level in the work environment is usually moderately loud.


Mentor Technical Group es un empleador que ofrece igualdad de oportunidades y todos los solicitantes calificados recibirán consideración para el empleo sin importar raza, color, religión, sexo, orientación sexual, identidad de género, información genética, origen nacional, estado de veterano protegido, estado de discapacidad o cualquier otro grupo protegido por ley.

Mentor Technical Group is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, genetic information, national origin, protected veteran status, disability status, or any other characteristic protected by law.