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
Back to blog

Other Jobs To Apply

Part-Time YouTube Video Editor | Taylor & Lauren

Part-Time Weekend / Night Shift Customer Service Associate

Manager Revenue Management - Pricing

Permit Operations Lead (Fully Remote)

Senior Lead Business Accountability Specialist – CBL Sanctions Risks and Initiatives

Apple Device Specialist (Mac, iPhone & Apple Ecosystem Expert)

Appointment Setter

DevOps Engineer – Cloud Infrastructure

amazon work from home $15+/ Hour (Sign on Bonus!)!

DevOps Engineer – Cloud Infrastructure

amazon work from home $15+/ Hour (Sign on Bonus!)!

Executive Personal Assistant to the Founder (Remote, UAE or Europe)

Licensed Remote Pharmacy Technician (Texas Only)

Remote Work From Home Data Entry Clerk / Typing

[Entry Level/No Experience] Tesla Part Time Rem

Apprentice Electrician

Remote Independent Contractor Role: Customer Service, Paid Weekly, $15 - $19 per hour

Pre-Service Patient Estimate Rep- Remote

Remote Data Entry Specialist – Flexible Remote Work, Immediate Start, Competitive Hourly Rate, Full Training Provided

icreatives is hiring: Graphic Design / Creative Design (Remote) in Miami

కాల్ సెంటర్ బిపిఓ ఎగ్జిక్యూటివ్

Editorial Quality Specialist – American English Copy Editing | $60/hr Remote

Remote Video Game Annotator for AI Training

_ Remote Entry Level Jobs (No Experience Needed) | Start ASAP | Flexible Schedule

Remote Medical Transcriptionist

Remote Web Gaming Test Operator (Hiring Immediately)

Remote Authorization Specialist (Afternoon-Evening or Weekends)

Electrician (Apprentice)

Customer Success Manager Remote (NY, IN, OH) - Direct Tax

Sr. Associate, Process Manager - Business Cards & Payments (Work From Home)

Remote Part-Time Transcriptionist

High-Paying Remote Customer Service Jobs - Starting at 19 Per Hour

Medical Transcription Reviewer - Fully Remote

Field Service Technician, Utility

Process Assistant

Entry-Level Freight Dispatcher (Remote) – Earn $2,200 to $3,000 Weekly ($114,400–$156,000 Annually)

Entertainer (Cruise Ship)

Part-Time Weekend / Night Shift Customer Service Associate

Client Services Representative

Registered Nurse - Fully Remote

Paid Product Tester

Senior Level Designer - BEYOND GOOD & EVIL 2 (F/H/NB)

Strategic Communications Lead for Explorer Programs

Data Entry Clerk Work From Home - Part Time Focus Group Panelists (Up To $750/Week) - Now Hiring

HealthShare Application Engineer- Overnight Shift Remote Opportunity

Senior Corporate Lending Officer - Commercial C&I (remote)

Real Estate Associate Agent at Rocket Mortgage: 100% Remote (Grand Rapids, MI, Lansing)

Entry-Level Data Entry Operator

CVS Remote Jobs Near Me $25/Hour

iCloud & Apple ID Readiness PM - Release & Support

Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...