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Medical Claims Manager Jobs in Roxbury, MA (NOW HIRING)

Jonus Group

Workers Compensation Claims Director

Boston, MA · On-site

$120 - $140/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Strong technical knowledge of Workers' Compensation claims, including indemnity, medical, litigation, reserving, settlement, and return-to-work strategies. * Demonstrated experience managing complex ...

New

Auto-Owners Insurance

Claims Supervisor 1

Westborough, MA · On-site

$75K - $90K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Regularly update management regarding the progress in meeting objectives and problems involving ... This includes medical, vision, dental, life insurance, disability insurance, and a generous paid ...

Aoins

Claims Supervisor 1

Westborough, MA

$75K - $90K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Regularly update management regarding the progress in meeting objectives and problems involving ... This includes medical, vision, dental, life insurance, disability insurance, and a generous paid ...

Hiscox

Complex Claims Specialist

Boston, MA · Hybrid

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Complex Claims Specialists are empowered to manage their claims with high levels of authority to ... Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and ...

Hiscox

Complex Claims Specialist

Boston, MA · Hybrid

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Complex Claims Specialists are empowered to manage their claims with high levels of authority to ... Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and ...

Suffolk Construction

Claims Specialist

Boston, MA · Hybrid

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Claims Specialist under the supervision of the Director of Claims is responsible for ... Determine when vendor involvement is necessary, such as medical case management, vocational ...

MG+M The Law Firm

Claims Monitoring Counsel

Boston, MA · On-site

$120K - $190K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

The Consulting Group provides risk management and claims monitoring services and strategic advice ... medical, dental, vision, life, disability, and 401(k). MG+M will not discriminate in its employment ...

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Showing results 1-20

All JobsMedical Claims JobsMedical Claims Manager JobsMedical Claims Manager Jobs in Roxbury, MA

Medical Claims Manager information

See Roxbury, MA salary details

$38K

$95.4K

$150.8K

How much do medical claims manager jobs pay per year?

As of Aug 16, 2026, the average yearly pay for medical claims manager in Roxbury, MA is $95,352.00, according to ZipRecruiter salary data. Most workers in this role earn between $73,800.00 and $114,000.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a medical claims manager?

To thrive as a Medical Claims Manager, you need a strong background in healthcare administration, claims processing, and knowledge of insurance regulations, typically supported by a bachelor's degree in a related field. Familiarity with claims management systems, billing software, and certification such as Certified Professional Coder (CPC) are often required. Exceptional attention to detail, problem-solving abilities, and effective communication set top performers apart. These skills ensure accurate claims processing, regulatory compliance, and efficient resolution of disputes, which are critical for organizational success.

What are some common challenges medical claims managers face when overseeing claims processing teams?

Medical Claims Managers often encounter challenges such as keeping up with changing healthcare regulations, ensuring accurate and timely claims processing, and managing workflow during periods of high claim volume. They must also address discrepancies or denials efficiently and provide ongoing training to team members to maintain compliance and quality standards. Effective communication with insurance carriers, healthcare providers, and internal teams is crucial to resolving issues and streamlining operations.

What does a medical claims manager do?

A Medical Claims Manager oversees the processing of insurance claims related to healthcare services. They ensure that claims are handled efficiently, accurately, and in compliance with industry regulations. Their responsibilities include supervising claims staff, reviewing and resolving complex claims issues, and coordinating with healthcare providers and insurance companies. Medical Claims Managers also work to identify and prevent fraudulent claims and improve overall claims processing procedures.

What cities near Roxbury, MA are hiring for Medical Claims Manager jobs?

Cities near Roxbury, MA with the most Medical Claims Manager job openings:

Medical Claims Manager jobs near you
Infographic showing various Medical Claims Manager job openings in Roxbury, MA as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 15% Part Time, and 6% Contract. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution, with an average salary of $95,352 per year, or $45.8 per hour.

Workers Compensation Claims Director

Jonus Group

Boston, MA • On-site

$120 - $140/hr

Other

Medical, Dental, Vision, Retirement, PTO

Posted 2 days ago

New

Job description

Overview:

Our insurance client is seeking an experienced Workers’ Compensation Claims Director to lead claims operations and provide strategic direction across the organization’s Workers’ Compensation portfolio. This individual will oversee claims performance, ensure quality and regulatory compliance, develop claims strategies, and lead a team of claims professionals in delivering exceptional outcomes for policyholders and business partners.

The ideal candidate will bring a strong technical Workers’ Compensation background, proven leadership experience, and a track record of improving claims outcomes, controlling loss costs, and developing high-performing claims teams.

Compensation & Benefits:
  • $120,000 - $140,000/year based on experience
  • Comprehensive benefits package including medical, dental, vision, and 401(k)
  • Generous PTO and holiday schedule
  • Hybrid work flexibility
Qualifications/Requirements
  • Bachelor’s degree in Insurance, Risk Management, Business, or a related field preferred.
  • 8+ years of Workers’ Compensation claims experience, with progressively increasing responsibility.
  • 3+ years of claims management or leadership experience required.
  • Strong technical knowledge of Workers’ Compensation claims, including indemnity, medical, litigation, reserving, settlement, and return-to-work strategies.
  • Demonstrated experience managing complex and high-exposure Workers’ Compensation claims.
  • Experience managing claims teams and developing high-performing claims professionals.
  • Strong understanding of Workers’ Compensation regulations and compliance requirements across multiple jurisdictions.
  • Proven ability to analyze claims data, identify trends, and develop strategies to improve loss results.
Responsibilities
  • Provide strategic leadership and oversight of the Workers’ Compensation Claims Department, including indemnity and medical claims.
  • Direct day-to-day claims operations and ensure claims are handled in accordance with company guidelines, regulatory requirements, and industry best practices.
  • Lead, coach, mentor, and develop claims professionals while establishing performance expectations and measurable goals.
  • Oversee claim investigation, compensability determinations, reserving, litigation management, settlement negotiations, and claim resolution.
  • Monitor claims performance, loss trends, reserve adequacy, and key performance indicators to identify opportunities for improvement.
  • Develop and implement claims strategies designed to improve outcomes, reduce claim costs, and enhance operational efficiency.
  • Provide technical expertise and guidance on complex Workers’ Compensation claims, including catastrophic and litigated exposures.
  • Partner closely with underwriting, actuarial, risk management, legal, finance, and other internal stakeholders.
  • Oversee relationships with TPAs, defense counsel, medical providers, vendors, and other external partners.
  • Ensure compliance with applicable Workers’ Compensation laws, regulations, company policies, and service standards.
  • Review claims trends and analytics to identify emerging exposures and recommend appropriate action.
  • Establish and maintain effective claims procedures, controls, and quality assurance standards.
  • Prepare and present claims performance updates, trends, financial results, and strategic recommendations to senior leadership.
  • Support budgeting, forecasting, and financial management for the Claims function.
  • Stay current on Workers’ Compensation legislation, regulatory developments, litigation trends, and industry best practices.
  • Drive continuous improvement initiatives and identify opportunities to enhance the customer and policyholder experience.
  • Perform other duties and special projects as assigned.

Disclaimer: Please note that this job description may not cover all duties, responsibilities, or aspects of the role, and it is subject to modification at the employer's discretion.

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About Jonus Group

Sourced by ZipRecruiter

The Jonus Group is a prestigious staffing agency located in Wayne, PA, the United States that specializes in the insurance industry. Since its inception, the Jonus Group has been committed to connecting skilled industry-specific candidates with leading insurance companies across the nation. The firm stands out for its broad-based experience in permanent, temporary and temp-to-hire staffing, proving its flexible approach to addressing diverse client needs. Foundational to the Jonus Group’s operations are its core values - excellence, integrity, and client focus. The firm's mission is to serve as a bridge between talent and opportunity, focusing on establishing mutually beneficial, long-lasting relationships between job seekers and employers. A key achievement of the Jonus Group has been its ability to position itself as a reliable go-to resource for staffing solutions in the insurance industry.

Industry

Insurance services

Company size

11 - 50 Employees

Headquarters location

Wayne, PA, US

Year founded

2012

Social media

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