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