Senior Claims Process Improvement Specialist

Location: Remote

About the Role

Are you passionate about driving meaningful change and improving how work gets done? As a Senior Claims Process Improvement Specialist, you'll lead high-impact initiatives that transform Claims operations, partner with leaders and cross-functional teams to streamline processes, implement innovative solutions, and deliver measurable business results. This role offers the opportunity to influence strategic decisions, leverage data-driven insights, and help shape the future of the Claims organization through continuous improvement and operational excellence.

Responsibilities

• Collaborate with Claim leaders to develop change management and implementation strategies for large scale projects or initiatives
• Conduct need analysis assessments
• Gather and document business requirements
• Identify gaps and operational functions in need of improvement
• Design and document process enhancements and recommended workflows
• Execute projects ensuring adherence to corporate and regulatory guidelines
• Analyze data to determine the root cause of operational inefficiencies
• Participate in cross-functional teams performing cost-benefit analysis and budget implications
• Identify, analyze, and recommend innovative approaches to resolve highly complex problems
• Forecast and communicate project outcomes to Claims leadership
• Document and maintain process flows and procedures
• Measure and track achievement of project objectives and timelines
• Work with technology and functional teams on the implementation of Claims system or solutions
• Lead business readiness activities and organizational change management to ensure end users are prepared for system upgrades, changes or new technology or functional solutions
• Participate in the development of training related to process improvement solutions

Requirements

• Bachelor’s degree in related field
• A valid driver's license is required if the primary responsibilities of the role involve conducting in-person inspections or frequent in-person meetings with members
• Minimum of 4 years of claim handling experience
• Experience in process improvement activities including evaluating, analyzing, recommending, documenting, and implementing improvements in processes and procedures
• Organizing, controlling, monitoring, and reporting projects including providing work direction and guidance to vendors or Claims teams
• Analyzing information flow and evaluating the effectiveness and efficiency of systems, solutions, and business strategies
• Conducting cost/benefit analysis
• Planning, organizing, and training others on new applications, processes, or vended solutions
• Implementing and evaluating performance interventions
• Analyzing and documenting workflows
• Project management, including planning and oversight
• Preparing and presenting information to management

Skills

• Strategic thinking and addressing complex issues
• Leading multifunctional project teams, including employees of various levels, including management
• Effective communication (both verbally and in writing)
• Analyzing potential new products and vendors
• Developing change management plans and leading business readiness activities
• Researching, analyzing, and presenting industry benchmarks and making recommendations
• Analyzing and defining resource and skill requirements for projects
• Participating in or leading process improvement initiatives
• Demonstrated strong problem solving and interpersonal skills
• Demonstrated strong organization and prioritization skills
• Effectively working on concurrent projects
• Setting priorities, multitasking, working under pressure, and adapting to changing demands
• Adapting to and effectively leading change

Preferred Qualifications

• Project Management Professional certification
• Experience presenting information using tools such as PowerPoint, Tableau or similar
• Creating and utilizing process flowcharts, and gap analysis using VISIO or other comparable tools
• Process improvement strategies and best practices
• Project management in a leadership capacity
• Knowledge of ACG claims systems
• Project management tools
• Multi-line claims operations exposure

Work Environment

This position is currently able to work remotely from a home office location for day-to-day operations, unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy.

Schedule

Monday – Friday: 8:30 AM EST – 5:00 PM EST

Pay

A Senior Claims Process Improvement Specialist earns a competitive annual salary of $76,000.00 - $100,000.00, along with the opportunity for an annual company bonus incentive.

Benefits

Health & Wellness

• Medical plans with multiple coverage options, including HSA eligibility
• Prescription drug coverage
• Dental and vision benefits
• Employee Assistance Program (confidential support services)

Financial Protection & Insurance

• Company-paid basic life insurance
• Optional supplemental life insurance and dependent coverage
• Short-term and long-term disability coverage
• Critical illness, accident, and pet insurance options

Retirement & Savings

• 401(k) plan to support long-term financial goals
• 3% automatic deferral upon eligibility; may contribute 1% to 50% of eligible earnings, either pre or post tax
• Company match of 50% paid on employee contributions up to 6% of pay, payable to employees following the end of the year; immediate vesting
• Additional company contribution of 4% of pay each pay day into your account; 100% vested after three (3) years of service
• Health Savings Account (HSA) and Flexible Spending Accounts (FSA) options

Time Off & Leave

• Paid Time Off (PTO): Accrual-based, increases with tenure, eligible at 90 days of employment. Full-time new employees will receive up to 12 PTO days annually; accrual based on start date and may include additional PTO based on role and/or state & local requirements. Part-time employee PTO hours are calculated based upon the standard weekly hours the employee is scheduled to work and will accrue at a minimum of 3 hours per month
• Paid Holidays: Full-time employees are eligible for 10 company-paid holidays annually, in addition to 1 mental health day, 2 floating holidays and 1 volunteer day. Part-time employees are eligible for 8 company-paid holidays annually, in addition to 1 mental health day and 2 floating holidays
• Paid leave programs, including parental, bereavement, jury duty, and military leave

Career Growth & Education

• Tuition assistance (up to $5,250 annually; 80% covered by ACG)
• Professional certification support with 100% reimbursement for eligible programs
• Opportunities for career development and advancement

Additional Perks

• Complimentary AAA membership with roadside assistance and travel discounts
• Adoption assistance program