Senior Insurance Claims Specialist

Job Description:

  • Assess risk and severity on the most complex or sensitive incidents and recommend next steps
  • Own high-severity escalations through closure
  • Coordinate with Legal, Risk & Insurance, Actuarial, and Quality Assurance partners
  • Serve as a go-to resource and subject matter expert for Claims Specialists
  • Identify patterns, root causes, and process, policy, or workflow gaps
  • Utilize, help build, and scale AI-enabled tools and automation
  • Provide frontline feedback shaping AI tool rollout
  • Review case work and share quality feedback
  • Help close skill gaps on the team
  • Contribute to training materials, playbooks, and process documentation
  • Help the team navigate process, tool, and policy changes
  • Report to a Supervisor, Insurance Claims Operations

Requirements:

  • 4+ years of hands-on claims operations experience, including bodily injury, property, Commercial Auto, General Liability, or Workers' Compensation claims
  • Experience assessing risk and severity on high-value or sensitive claims
  • Strong risk-assessment skills, including judging severity and exposure and knowing when and how to escalate
  • Experience mentoring or informally guiding less experienced Claims Specialists
  • Strong analytical and problem-solving skills
  • Ability to identify root causes and recommend corrective action
  • Comfort utilizing, building, and scaling AI-enabled tools and automation
  • Ability to provide feedback that improves AI-enabled tools and automation
  • Strong written and verbal communication skills, including with external carrier and TPA partners
  • Ability to handle sensitive and confidential information with discretion
  • Extremely solution-oriented mindset
  • Education is optional

Benefits:

  • Equity grant opportunities
  • 401(k) plan with employer matching
  • 16 weeks of paid parental leave
  • Wellness benefits
  • Commuter benefits match
  • Paid time off
  • Paid sick leave
  • Medical benefits
  • Dental benefits
  • Vision benefits
  • 11 paid holidays
  • Disability insurance
  • Basic life insurance
  • Family-forming assistance
  • Mental health program
  • Flexible paid time off/vacation for salaried roles
  • 80 hours of paid sick time per year for salaried roles
  • Wellness expense reimbursement
  • Premium healthcare
  • Accommodations for applicants with disabilities
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