Policy Administrator at Allianz Partners managing data - entry and analysis tasks within health and life insurance services. Focus on maintaining quality outputs and communication with stakeholders for pricing adjustments.
BC
Hybrid Claims Operations Associate
Posted 4 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
IT Operations Engineer solving tech issues and supporting desktop technology across various locations. Ensuring productivity through troubleshooting and IT project management.
Satellite Operations Technician providing Tier 1 and Tier 2 satellite and network operations support. Maintaining and monitoring satellite communication networks at SES Space & Defense in Tampa, FL.
Supervisor for Supply Chain Operations overseeing efficient warehouse operations. Leading and training teams for optimal performance in logistics with a focus on quality service.
Operations Supervisor overseeing daily warehouse operations at GXO, a leading supply chain solutions provider. Managing team performance and ensuring exceptional service delivery.
Supervisor managing supply chain operations at GXO with responsibilities in warehouse efficiency. Fostering team performance through training and quality assurance for optimal customer service.
Senior Project Operations Manager at GXO responsible for efficient project execution and team leadership. Ensure adherence to project timelines and delivery standards while fostering a positive work environment.
Operations Supervisor overseeing warehouse operations and team performance at GXO Logistics. Ensuring efficient processes and high - quality service in the supply chain.
Manager, Supply Chain Operations overseeing logistics and performance while leading a team at GXO. Fostering an efficient operation to ensure quality service and workforce engagement.
Supervisor in Supply Chain Operations at GXO Logistics ensuring efficient daily warehouse operations and team training. Supporting quality policy adherence to enhance customer service and operations.