Junior Operations Oversight & Process Specialist

As an Operations Oversight & Process Specialist your job will be to perform assessments on multiple aspects of a claim journey. Assessments could include evaluating execution of standard operating procedures, claims policies and contractual agreements, customer experience, and/or identify opportunities in system functionality. A Claims Assessment Specialist should be able to provide recommendations to improve quality, workflow processes, policies, and system improvements.
This role will report a claims team manager.
* Review and evaluate claim/process to determine if proper practices are followed.
* Understand complex and highly technical processes to identify any associated risks.
* Maintain knowledge of multiple programs, products and sets of terms and conditions.
* Take responsibility in identifying and reporting process improvements and assist in building new processes.
* Provide detailed written feedback to managers for agent development and business operations.
* Participate in calibration sessions to ensure process/agent review consistency among all business units.
* Maintain a professional and collaborative partnership with various teams and individuals within the organization.
* Maintain and consistently track claim review results for upward feedback.
* Handle research assignments and reporting as delegated by management.
* Act professionally always.
* Perform additional duties and work as assigned.
* 1+ year of relevant work experience
* Critical thinker
* Meticulous attention to detail
* Excellent problem-solving skills
* Ability to work on own initiative and as part of a team
* Analytical skills
* Results oriented, and able to work well under pressure
* Excellent organizational skills
* Flexible with moving from project to project while keeping track of progress
* Ability to consistently meet deadlines
* Knowledge of insurance claims process is a plus
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