Role Purpose:
The primary purpose of this role is to collaborate closely with the Claims Manager to drive and implement strategic process improvements initiatives that optimize team efficiency while prioritizing exceptional customer service.
The position is also accountable for developing and implementing a comprehensive framework for various claims support functions, including Reporting & Metrics, Quality Audits, and Training. This framework will ensure that critical insights are generated from performance data, maintain high-quality standards through systematic audits, and provide structured training programs that equip team members with the necessary skills and knowledge to excel in their roles.
Key Responsibilities:
1. Engage with various stakeholders and conduct regular assessments of existing claims processes to identify inefficiencies, bottlenecks, and opportunities for improvement.
2. Utilize data analytics and performance metrics to evaluate the impact of current processes on team efficiency and customer satisfaction.
3. Lead the design and execution of process improvement projects, employing methodologies such as Lean, Six Sigma, or Agile to enhance operational workflows.
4. Collaborate with the Claims Manager to prioritize initiatives based on potential impact and alignment with organizational goals.
5. Oversee the collection and analysis of performance data to generate actionable insights that inform decision-making and strategy refinement.
6. Design and implement a systematic quality audit process to ensure compliance with internal standards and regulatory requirements.
7. Evaluate the effectiveness of training programs and make necessary adjustments to improve learning outcomes.
8. Assist organization in the creation, monitoring, measurement, and analysis of standardized processes.
9. Communicate to key management stakeholders on significant quality issues and business opportunities.
Experience:
• Experience working with cross functional teams across Operations and Support teams.
• Good interpersonal and communication skills – both written and verbal
• Effective time management is a critical requirement.
• Demonstrated experience in using management information/data insights to deep dive on problems and drive improved process and/or performance.
• Able to maintain positive and productive relationships with teams, peers, and manager(s), ensuring a high degree of responsiveness to requests.
• Exceptional coaching skills
Qualifications:
• Bachelor's Degree Graduate with at least minimum 3-4 years similar work experience
• At least Lean Six Sigma CERTIFIED
• With relevant experience in RPA, AI or Transformation.
• Claim Insurance background required