Senior Insurance Claims Specialist

October 3, 2026

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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:

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