Claims Communication and Process Enablement Lead

Berkshire Hathaway Homestate Companies - Workers Compensation Division · San Francisco Bay Area · 3 wk ago

HybridMarketing$106k–$132k/yrFull-time

Responsibilities

Berkshire Hathaway Homestate Companies, Workers Compensation Division, is searching for a Claims Communication and Process Enablement Lead to join its Adjusting Team!

This individual is responsible for translating Claims strategy, system changes, and workflow design into clear, consistent, and executable practices across the Claims organization. This individual establishes and maintains disciplined standards for workflow documentation, job-level execution, and practical job aids, ensuring that leadership intent is understood, adopted, and executed consistently along frontline teams.

Partners closely with Claims leadership, Transformation, and Technology to ensure change is implemented with clarity, consistency, and accountability.

ESSENTIAL RESPONSIBILITIES

OWNS END-TO-END DOCUMENTATION OF CRITICAL CLAIMS WORKFLOWS ACROSS ADJUSTING, MEDICAL MANAGEMENT, AND OPERATIONAL SUPPORT FUNCTIONS
TRANSLATES COMPLEX WORKFLOWS INTO CLEAR, STRUCTURED PROCESS MAPS AND EXECUTION STANDARDS
EQUIPPES FRONTLINE TEAMS WITH HIGH-QUALITY JOB AIDS THAT SUPPORT REAL-TIME DECISION MAKING
MONITORS EXECUTION CONSISTENCY ACROSS TEAMS AND IDENTIFIES GAPS BETWEEN DEFINED STANDARDS AND ACTUAL PRACTICE
DRIVES CONTINUOUS REFINEMENT OF WORKFLOWS, JOB AIDS, AND COMMUNICATION PRACTICES

Qualifications

EDUCATION
Bachelor's degree from an accredited four-year college or university.
LICENSES AND CERTIFICATIONS
One or more preferred:

Licensed to adjust workers compensation claims in one or more jurisdictions.
Prosci Change Management Certification or Certified Change Management Professional (CCMP).
Project Management Professional (PMP).

EXPERIENCE
A minimum of seven (7) years of experience in workers compensation claims management, claims operations, or closely related functions.
Demonstrated experience translating complex processes into clear, structured, and actionable guidance.
PROVEN EXPERIENCE WITH CLAIMS MANAGEMENT SYSTEMS (CMS).
Experience supporting or leading operational change initiatives, including system implementations or workflow designs; experience driving adoption, not just awareness.
TECHNICAL KNOWLEDGE/SKILLS
Deep understanding of end-to-end Claims workflows, including Adjusting, Medical Management, and regulatory considerations.
Strong process orientation with ability to simplify complexity without losing substance.
Ability to convert strategy and system design into practical execution.
Strong ability to influence without direct authority across multiple levels of the organization.
Demonstrated proficiency in Microsoft Office suite of applications, Power BI, and currently adopted proprietary and vendor software programs.
ABILITY TO MASTER AND BECOME PROFICIENT IN ADDITIONAL PROPRIETARY AND VENDOR SOFTWARE PROGRAMS.
Critical Thinking
Ability to think critically and adapt quickly in a flexible and dynamic environment.
Proactive and inquisitive approach to work.
ABILITY TO DERIVE APPROPRIATE CONCLUSIONS FROM DATA AND VARIOUS SOURCES AND APPLY EFFECTIVELY.
LANGUAGE ABILITY
Ability to read, analyze, and interpret Claims laws and regulations, medical documentation, general business periodicals, professional journals, technical procedures, and data from various sources.
ABILITY TO DEVELOP CLEAR, ACTIONABLE WORKFLOWS/SOPs MAINTAINING STRICT ADHERENCE TO REGULATIONS, AND EFFECTIVELY COMMUNICATE THEM TO STAKEHOLDERS/USERS BOTH IN INDIVIDUAL CONVERSATIONS AND PRESENTATIONS TO GROUPS.
ABILITY TO WRITE EFFECTIVE BUSINESS CORRESPONDENCE AND CLEAR, CONCISE PROCEDURES.
MATH AND REASONING ABILITY
Ability to solve practical problems and deal with a variety of variables in situations where only limited standardization exists.
ABILITY TO INTERPRET INSTRUCTIONS FURNISHED IN WRITTEN, ORAL, DIAGRAM, OR SCHEDULE FORM.

What We Offer

HYBRID WORK SCHEDULE (UP TO 2 DAYS WORK FROM HOME UPON ELIGIBILITY)
Paid Time Off
Paid Holidays
Immediate Vesting of Retirement Savings + Company Match
Group Health Insurance (Medical, Dental, and Vision)
Life and AD&D Insurance
Long Term Disability Insurance
Hospital Indemnity Insurance
Accident and Critical Illness Insurance
Flexible Savings Accounts
Paid Community Volunteer Day
Employee Assistance Program
Tuition Reimbursement Program
Employee Referral Program
Diversity, Equity and Inclusion Program
$106,261 - $132,375 a year

Pay Scale

The pay scale is an estimate of the salary range the employer reasonably expects to pay for the position based on potential employee qualifications, operational needs and other considerations consistent with applicable law. The actual salary may be above or below the range. The pay scale applies only to this position and only if it is filled in the Bay Area, California. The pay scale may be different for other positions or in other locations.

About the Role