AVP – Claims Operations

Role Overview

• Develops and oversees the implementation of strategic plans and initiatives for the claim advocacy team, optimizes claim resolution outcomes and enhances client satisfaction.
• Leads the team of Claims Advocacy Specialists, provides direction and mentorship to ensure effective claims handling.
• Manages escalations of complex claims issues, provides guidance, and delivers resolution.
• Collaborates with senior management to formulate and execute strategic initiatives that deliver organizational growth, enhance profitability, and maintain a competitive edge in the market.
• Fosters and nurtures strong relationships with key clients, insurance carriers, and industry stakeholders.
• Leads collaborative efforts with underwriters, legal counsel, and senior management to devise and execute innovative strategies for claims management and risk mitigation.
• Represents business interests in complex negotiations with insurance carriers, clients, and other stakeholders while ensuring regulatory compliance.
• Conducts regular performance assessments, audits, and evaluations to gauge team effectiveness, identifies areas for improvement and implements corrective measures as needed.
• Spearheads initiatives aimed at bolstering operational efficiency, streamlines claim handling procedures, and optimizes resource allocation within the claim advocacy team.
• Stays abreast of industry trends, regulatory shifts, and emerging risks to proactively identify opportunities for refining processes and adapting claims advocacy strategies.

Requirements

• 6+ years of experience in the Insurance Claims Processing and advocacy
• Associate in Claims (AIC) or Certified Claims Professional (CCP) preferred
• Bachelor’s degree; Finance, Legal, Business Administration preferred
• Any other related discipline or commensurate work experience considered

Benefits

• paid time off for company holidays
• vacation
• sick and personal days
• paid parental leave
• mental health services and more