Claims Operations Specialist
$75,000–$100,000 year
Remote · United States
Job Summary
Claims Operations Specialist responsible for managing the overall claims reporting process to carrier partners, producing accurate bordereaux, driving data quality improvements, and coordinating inquiries with carrier partners. Focus on data reconciliation, process improvements, and ensuring compliance in invoicing, payment enablement, and controls. Collaborates with Claims, Actuarial, Data, Product, and Engineering; supports audits and internal/external reviews. Emphasizes data-driven insights, operational efficiency, and leveraging analytics/Gen-AI to enhance productivity and customer experience.
Required Qualifications
- 4+ years of experience in insurance claims operations
- Excellent data analysis and systems savvy
- Understanding of insurance concepts
- Customer service, creative problem solving mindset
- Salesforce experience a plus
- Advanced Excel and data management skills, with experience handling large datasets
- Experience as a heavy contributor or leader of a cross functional product/process
- Superior written and verbal communication skills
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