Claims Experience and Resolution Specialist

Coterie Insurance; United States; Remote; USD 65,000 - 75,000; Full time

Job summary

An innovative firm is seeking a Claims Experience and Resolution Specialist to redefine how small businesses experience insurance. This role involves collaborating with internal teams and external partners to drive best-in-class outcomes while ensuring compliance and efficiency. You'll handle customer complaints, support training programs, and contribute to process improvements. Join a forward-thinking company that values integrity and passion, and be part of a mission to reshape a $200B+ market. If you're ready to make a significant impact in a dynamic environment, this opportunity is for you.

Benefits

100% remote work

Health insurance (100% paid premiums)

Dental and vision insurance (100% paid premiums)

Basic life insurance (100% paid premiums)

401K plan with 4% match

Flexible PTO

Continuing education stipend

12 company-paid holidays

Qualifications

• 5+ years of experience in claims handling, operations, or insurance support.
• Strong knowledge of claims workflows and QA expectations.

Responsibilities

• Draft and handle formal customer complaints from start to resolution.
• Monitor operational trends and propose improvements.

Skills

Claims Handling

Process Management

Analytical Skills

Communication Skills

Customer Service

Education

Bachelor's Degree in a related field

Tools

Claims Management Software

Performance Tracking Tools

Job description

Claims Experience and Resolution Specialist

Who we are:
Through a partnership-based approach, Coterie helps insurance professionals unlock untapped revenue in the small commercial space. With an innovative quoting platform that delivers accurate pricing and bindable quotes in less than one minute, Coterie makes small business insurance effortless.

We are on a mission to build and foster a world-class team to bring speed, simplicity, and service to commercial insurance. We value integrity, humility, passion, and intelligence. If you want to push yourself and reshape a $200B+ market, we’re excited to talk to you!

What will the Claims Experience and Resolution Specialist do?
Coterie is redefining how small businesses experience insurance, and we are looking for a Claims Experience and Resolution Specialist , assist our Claims Operations “Pod” team, contribute to our Quality Assurance and Quality Control (QA/QC) program, and be a key contributor to process and experience improvement initiatives across the department. You'll work cross-functionally with internal stakeholders and external partners to drive best-in-class outcomes and ensure strategic, compliant, and efficient resolution strategies are implemented.

Core Hours Needed: Monday-Friday 8:00am-5:00pm EST time zone

Key Responsibilities

• Drafting, track, and handle, through resolution, of all formal customer complaints from first notification to final resolution, some of which can be complex and sensitive in nature.
• Review and process coverage determinations for claims that have been identified to be potential coverage disclaimers; assist in the review and processing of coverage disputes.
• Support training and onboarding programs through documentation and workflow optimization.
• Monitor operational trends, customer feedback, and team performance data to identify gaps and propose improvements.
• Collaborate on automation, claims system enhancements, and user experience projects.
• Assist in special projects, pilots, and scaling strategies to support growth and improve operational outcomes.
• Engage with team members to monitor file handling trends, ensure compliance with resolution strategy, and participate in governance sessions and training reviews with staff.
• Support claims handling by documenting communications, performing initial triage, and ensuring accurate data entry within the claims system.
• Serve as the front-line contact for calls and emails, providing prompt, professional assistance to policyholders, agents, and internal teams.
• Manage shared inboxes and coordinate with internal teams to route inquiries, escalate urgent matters, and ensure timely resolution of requests.
• Assist with payment claims processing, including follow-up on status inquiries or discrepancies.
• Maintain organized and up-to-date claim file records, support ad-hoc administrative duties, and contribute to department meetings and initiatives.

What we are looking for

• 5+ years of experience in claims handling, operations, process management, or insurance support.
• Strong knowledge of claims workflows, QA expectations, and service protocols.
• Excellent communication skills and analytical capabilities.
• Comfortable working in a fast-paced, remote-first, tech-forward environment.
• Adept at claim system tools, diary management, and performance tracking in a remote-first environment.
• Active claims license and willingness to get licensed countrywide.
• Knowledge of insurance claims and other related software applications.
• Knowledge of commercial insurance coverages, policy language.
• Ability to read, prepare, comprehend, and analyze complex documents and reports.
• Analytical skills to assess situations and potential improvements, with the ability to effectively communicate findings in person or through documentation/reporting.
• Ability and willingness to present to senior management and to others.
• Strong interpersonal, written, and verbal communication skills.
• Knowledge of the insurance industry claims process and legal and regulatory environment.
• Experience working with teams that use internal and third-party agents.

What will make you stand out:

• Insurance designations are a bonus
• Experience in QA, Continuous Process Improvement, UX/UI, Design Thinking, Lean, Agile, Project Management, and/or Product Ownership
• Active P&C (Property & Casualty) Insurance License
• Experience working in a start-up, insurance environment

Our hiring process generally consists of 4 phases. The goal is to provide an opportunity for us to learn more about our candidates while allowing them to get to know us as well!

• Phase 1 : Qualified candidates will first meet with a member of our People Operations team for a phone interview. This discussion is a high-level conversation to understand more about your background and interests and for us to share more about Coterie and the position.
• Phase 2 : Selected candidates will be invited to participate in our PDP survey and meet with our Hiring Manager for a 2nd interview via Teams video. This interview is designed to be more detail oriented and allows you to learn more about the role and expected to be 30 minutes in length.
• Phase 3 : Top candidates will be invited to participate in an experiential exercise interview. This will include a project provided in advance along with a 1-hour interview conducted with our hiring manager.
• Phase 4: Final candidates will receive an invite to our final interview series. This series will include 1:1 interviews with additional team members. The final series is roughly 1-2 hours in total.

What's in it for you:

Coterie has excellent benefits for all full-time employees. We offer the following:

• 100% remote
• Health insurance through Aetna (we pay 100% of premiums)
• Dental and vision insurance through Guardian (we pay 100% of premiums)
• Basic life insurance (we pay 100% of premiums)
• Access to flexible spending account (FSA) or health savings account (HSA) (for those using HSA eligible plans)
• 401K plan (up 4% match with immediate vest). Must be 21 years of age or older to participate
• Flexible PTO and 12 company-paid holidays each year
• Continuing education annual stipend
• Annual salary estimated between 65,000-75,000 based on national data. Candidates who meet all the minimum requirements and possess additional relevant experience, as outlined in the job description, may be considered for a salary above the midpoint of the above range. Salary is based on internal equity; internal salary ranges; market data/ranges; applicant’s skills; prior relevant experience; degrees or certifications, etc.

Work Authorization:
At this time, Coterie Insurance is unable to consider candidates who require current or future visa sponsorship. Applicants must have authorization to work in the United States without the need for sponsorship now or in the future. Falsification of an application, including work authorization status, is immediate grounds for dismissal from consideration.