Manager of Service Operations at Mindray North America, leading customer - focused service processes. Overseeing service workflows and team performance within a healthcare technology environment.
BC
Hybrid Claims Operations Associate
Posted 2 months ago
About the role
- Claims Operations Associate responsible for maintaining service standards and managing workflows. Working with Berkshire Hathaway GUARD to provide operational support in claims operations.
Responsibilities
- Assist in keeping service standards on track
- Ensure regulatory and litigation workflows run smoothly
- Equip adjusters and leaders with accurate, timely operational intelligence
- Service compliance & QA
- Audit callback alerts
- Track call answer rates and trends
- Maintain and publish the Litigation Calendar for the Complex Unit
- Submit external subpoenas via approved vendors; process external subpoena responses
- Prepare Utilization Review determination responses and manage medical-records uploads
- Build/maintain transfer templates to move files between Complex and Lien units
- Draft “no coverage” letters in partnership with the Coverage team
- Review Legal Ops invoices for accuracy and policy alignment
- Process overflow work: adjuster alerts, ISO activity, FROI filings, and related File reviews
- Coordinate review schedules with leaders and insureds
- Standardize and collect claim summaries, ensuring completeness ahead of reviews
- Flex to support priority initiatives and stakeholders when volume or complexity spikes.
Requirements
- Experience in Workers’ Compensation claims operations or shared services
- High School Diploma / GED (required)
- Familiarity with subpoena workflows, litigation calendars, UR determinations, ISO ClaimSearch, and FROI filings
- Strong data skills (Excel/Sheets: formulas, pivot tables; comfort with dashboards/metrics)
- Clear, concise writing—especially for coverage letters and executive-facing summaries
- High ownership, organization, and follow‑through across multiple teams and deadlines
- Proficiency with Microsoft 365 (Outlook, Teams, SharePoint); ability to learn internal systems quickly
- Discretion and sound judgment when handling PHI/PII and sensitive claim materials
- Nice to have: Exposure to CCU/EIU/Lien unit operations and California claims practices
- Experience coordinating multi‑stakeholder reviews (insureds, counsel, vendors)
- Basic familiarity with invoice review and coverage analysis
Benefits
- Competitive compensation
- Healthcare benefits package that begins on first day of employment
- 401K retirement plan with company match
- Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays
- Up to 6 weeks of parental and bonding leave
- Hybrid work schedule (3 days in the office, 2 days from home)
- Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation)
- Tuition reimbursement after 6 months of employment
- Numerous opportunities for continued training and career advancement
- And much more!
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
TS
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