Manager, Claims Operations

About the role

This role oversees claims operations with a strong focus on process discipline, quality review, and team performance in a high-volume, customer-focused environment. The manager guides supervisors and employees through workload management, coaching, and escalation handling while helping drive a better member experience. The position also partners across the organization to improve operational effectiveness, ensure compliance, and support sound policy-based decisions.

Responsibilities

• Inspect and review claim files for quality and provide feedback
• Coach employees to align their contributions with overall strategies
• Identify and implement improvements for operational effectiveness and member experience
• Remove obstacles and facilitate change for teams
• Manage staffing, training needs, and workload for optimal productivity
• Monitor work to ensure adherence to processes and guidelines
• Handle escalations and make policy-based decisions
• Support career progression through skill development and guidance
• Develop and coach claims staff for results
• Identify risks associated with business activities and ensure compliance

Qualifications

• Bachelor's degree or 4 years of relevant experience in lieu of a degree
• 6 years of customer service or operational experience, with 5 years specifically in claims handling
• 2 years of team lead or supervisory experience
• Experience in data interpretation for decision-making
• Effective leadership and customer service skills
• Insurance adjuster license acquisition within 6 months of starting
• Willingness to work weekends
• Willingness to travel up to 25% of the time

Benefits

• Comprehensive medical, dental, and vision plans
• 401(k) and pension options
• Life insurance and parental benefits
• Adoption assistance
• Paid time off including holidays and volunteer hours
• Wellness programs and support for professional development

Compensation

$103,450 – $197,730 annually

Location & schedule

Remote position for US-based candidates only; no visa sponsorship available. Requires willingness to work weekends and travel up to 25% of the time.