Manager, Claims Operations
Metropolis
Country: United States of America
Location: Chicago, Illinois, United States
Time Type: Full Time
Posted On: November 18, 2024
The Company
Metropolis is an artificial intelligence company that uses computer vision technology to enable frictionless, checkout-free experiences in the real world. Today, we are reimagining parking to enable millions of consumers to just "drive in and drive out." We envision a future where people transact in the real world with speed, ease and convenience that is unparalleled, even online. Tomorrow, we will power checkout-free experiences anywhere you go to make the everyday experiences of living, working and playing remarkable - giving us back our most valuable asset, time.
The Role
Metropolis is looking for a Manager, Claims Operations to lead and enhance the claims management processes within the organization, focusing on industries such as insurance, healthcare, or other sectors where claims are a key business function. Below is an outline of the role, key responsibilities, required skills, and qualifications for this position:
Key Responsibilities:
- Claims Process Management:
- Oversee the end-to-end process of claims handling, ensuring that claims are processed accurately, efficiently, and in compliance with company policies and industry regulations.
- Monitor and optimize workflows to improve processing times, customer satisfaction, and cost control.
- Team Leadership:
- Lead and mentor a team of claims professionals (e.g., claims adjusters, analysts, and support staff).
- Provide guidance on handling complex claims or escalated issues and foster a culture of continuous improvement.
- Set performance goals, conduct regular performance reviews, and support training and development.
- Claims Quality Assurance:
- Implement quality assurance protocols to ensure that claims are handled in accordance with company standards and legal/regulatory requirements.
- Conduct audits and assessments of claims to identify areas for improvement and ensure compliance with industry best practices.
- Customer Interaction & Resolution:
- Handle customer escalations related to claims, ensuring resolution in a timely, effective, and empathetic manner.
- Work closely with customer service teams to ensure smooth communication and customer satisfaction regarding claims outcomes.
- Data Analysis & Reporting:
- Use data analytics to track key performance indicators (KPIs) like claims resolution times, claims accuracy, and customer satisfaction.
- Prepare and present regular reports to senior management regarding claims performance, trends, and areas for improvement.
- Process Improvement & Innovation:
- Identify and implement process improvements to streamline claims handling, reduce costs, and enhance efficiency.
- Keep up-to-date with industry trends, technologies, and regulatory changes that may impact claims operations.
- Cross-Department Collaboration:
- Collaborate with other departments such as underwriting, legal, finance, and compliance to resolve claims-related issues and ensure alignment across functions.
- Work closely with IT teams to ensure claims management systems are functioning optimally and may be involved in upgrading or implementing new claims technologies.
- Regulatory Compliance:
- Ensure that the claims process adheres to all relevant local, state, and federal regulations (e.g., HIPAA, GDPR, etc.) and company policies.
- Manage audits and provide necessary documentation during compliance reviews.
Skills and Qualifications:
- Leadership Skills: Strong ability to lead, motivate, and develop a high-performing team.
- Claims Expertise: In-depth knowledge of the specific claims processes, policies, and regulations related to the industry (e.g., insurance, healthcare, workers' compensation).
- Problem-Solving: Ability to resolve complex claims issues, balance customer needs with company policies, and make decisions that are both fair and in compliance with regulations.
- Analytical Skills: Proficient in analyzing claims data and performance metrics to drive decisions and process improvements.
- Communication Skills: Excellent verbal and written communication skills to interact with customers, employees, senior management, and external stakeholders.
- Attention to Detail: Strong focus on accuracy and compliance in claims processing.
- Project Management: Ability to manage multiple projects, initiatives, and deadlines simultaneously.
- Technological Proficiency: Familiarity with claims management software and tools (e.g., Guidewire, Xactware, or proprietary systems). Knowledge of automation and AI-based solutions can be a plus.
- Education: A bachelor’s degree in business, management, or a related field is typically required. Some employers may also value industry-specific certifications such as CPCU (Chartered Property Casualty Underwriter) or AIC (Associate in Claims).
Experience:
- Typically, employers seek candidates with 5+ years of experience in claims processing or claims management, including at least 2 years in a supervisory or managerial capacity.
- Industry-specific experience (e.g., health insurance, property and casualty, auto insurance) may be a prerequisite.
Join us in making a difference as we build our future. Metropolis is an equal opportunity employer, dedicated to diversity, equality, and inclusion, and provides equal employment opportunities to all employees and applicants for employment. Metropolis prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.