Claims Operations Manager (Remote)

Eames Consulting Group; United States; Remote; GBP 70,000 - 100,000; Full time

Benefits offered by this job

Remote work

Flexible hours

Job summary

Eames Consulting Group is assisting a fast-growing specialty insurer to hire a Senior Claims Operations professional into its global claims function. The role is highly data- and transformation-focused with a broad remit spanning Claims, Data, Technology, Reinsurance and Finance, and offers flexible remote working.

You will lead data-improvement initiatives, own end-to-end data flows with internal teams, insurers, TPAs and external partners, and partner with Technology to boost workflows,

Qualifications

• Significant experience in claims operations and data handling.
• Strong Excel capability for data processing and analytics.
• Experience working with TPAs and senior stakeholders is essential.

Responsibilities

• Lead claims operations and data improvement initiatives from problem to implementation.
• Own end-to-end flow of claims data across internal teams, insurers, TPAs and external partners.
• Ensure claims information is accurate, complete and received within timelines.
• Manage data queries, reconciliations and loss fund processes.
• Collaborate with Technology to improve workflows, automation and systems.
• Act as senior escalation point for operational claims issues.
• Support onboarding of new data sources and ensure data governance.
• Identify opportunities to improve scalability, governance and efficiency.

Skills

Claims operations

Excel

Stakeholder management

TPA coordination

Data transformation

Automation awareness

Tools

Excel

Job description

I’m working with a fast-growing specialty insurance business looking to hire a Senior Claims Operations professional into its global claims function. Our client has a very flexible working arrangement and therefore is open to those looking for remote working.

This is a broad, hands-on role sitting at the intersection of Claims, Data, Technology, Reinsurance and Finance, with responsibility for improving how claims data is received, processed, reconciled and ultimately used across the business.

Key responsibilities will include:

• Leading claims operations and data improvement initiatives from initial problem through to implementation.
• Owning and improving the end-to-end flow of claims data across internal teams, insurers, TPAs and other external partners.
• Ensuring claims information is accurate, complete and received within agreed timelines.
• Managing data queries, reconciliations and loss fund processes.
• Working closely with Technology teams to improve workflows, automation and system capability.
• Acting as a senior point of escalation and subject-matter expert for claims operational issues.
• Supporting the onboarding of new data sources and ensuring appropriate standards and controls are in place.
• Identifying opportunities to improve scalability, governance and operational efficiency.

We’re looking for someone with significant Claims Operations experience, ideally within the Lloyd’s, specialty or reinsurance market, who has a particularly strong understanding of claims data and operational processes.

A background in claims handling would be useful, but this is fundamentally an operations, data and transformation-focused position. Strong Excel capability, experience working with TPAs and confidence dealing with senior internal and external stakeholders will be important.

This would suit someone who enjoys getting into the detail of complex claims data while also having the experience and credibility to drive wider operational change.