Senior Claims Process Improvement Specialist
$76k - $100kAAA-The Auto Club Group
Job Type: Full time
Exempt/Non Exempt:
SalaryJob Description:
Location Details:
Remote
Position Schedule / Shift:
Monday – Friday: 8:30 AM EST – 5:00 PM EST
Position Summary:
Are you passionate about driving meaningful change and improving how work gets done? As a Senior Claims Process Improvement Specialist, you'll lead high-impact initiatives that transform Claims operations, partner with leaders and cross-functional teams to streamline processes, implement innovative solutions, and deliver measurable business results. This role offers the opportunity to influence strategic decisions, leverage data-driven insights, and help shape the future of the Claims organization through continuous improvement and operational excellence.
Key Responsibilities:
Collaborate with Claim leaders to develop change management and implementation strategies for large scale projects or initiatives
Conducts need analysis assessments
Gathers and documents business requirements
Identifies gaps and operational functions in need of improvement
Designs and documents process enhancements and recommended workflows
Executes projects ensuring adherence to corporate and regulatory guidelines
Analyzes data to determine the root cause of operational inefficiencies
Participates in cross-functional teams performing cost-benefit analysis and budget implications
Identifies, analyzes, and recommends innovative approaches to resolve highly complex problems
Forecasts and communicates project outcomes to Claims leadership
Documents and maintains process flows and procedures
Measures and tracks achievement of project objectives and timelines
Works with technology and functional teams on the implementation of Claims system or solutions
Leads business readiness activities and organizational change management to ensure end users are prepared for system upgrades, changes or new technology or functional solutions
Participates in the development of training related to process improvement solutions
Qualifications:
Required
Education:
Bachelor’s degree in related field
A valid driver's license is required if the primary responsibilities of the role involve conducting in-person inspections or frequent in-person meetings with members.
Experience:
Minimum of 4 years of claim handling experience
Experience in process improvement activities including evaluating, analyzing, recommending, documenting, and implementing improvements in processes and procedures
Organizing, controlling, monitoring, and reporting projects including providing work direction and guidance to vendors or Claims teams
Analyzing information flow and evaluating the effectiveness and efficiency of systems, solutions, and business strategies
Conducting cost/benefit analysis
Planning, organizing, and training others on new applications, processes, or vended solutions
Implementing and evaluating performance interventions
Analyzing and documenting workflows
Project management, including planning and oversight
Preparing and presenting information to management
Skills and Ability to:
Strategic thinking and addressing complex issues Lead multifunctional project teams, including employees of various levels, including management
Effectively communicate (both verbally and in writing)
Analyzing potential new products and vendors
Developing change management plans and leading business readiness activities
Researching, analyzing, and presenting industry benchmarks and making recommendations
Analyzing and defining resource and skill requirements for projects
Participating in or leading process improvement initiative
Demonstrated strong problem solving and interpersonal skills
Demonstrated strong organization and prioritization skills
Effectively works on concurrent projects
Setting priorities, multitasking, working under pressure, and adapting to changing demands
Adapting to and effectively lead change
Preferred
Education:
Project Management Professional certification
Experience in:
Presenting information using tools such as PowerPoint, Tableau or similar
Creating and utilizing process flowcharts, and gap analysis using VISIO or other comparable tools
Process improvement strategies and best practices
Project management in a leadership capacity
Knowledge of:
ACG claims systems
Project management tools
Multi-line claims operations exposure
Work Environment:
This position is currently able to work remotely from a home office location for day-to-day operations, unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy.
Compensation & Benefits Overview:
ACG complies with all applicable state and local laws regarding required benefits (including PTO, paid sick leave, etc.).
Compensation
A Senior Claims Process Improvement Specialist earns a competitive annual salary of $76,000.00 - $100,000.00, along with the opportunity for an annual company bonus incentive.
Benefits
At ACG, we offer a comprehensive and flexible benefits package designed to support your health, financial well-being, and professional growth.
Health & Wellness
Medical plans with multiple coverage options, including HSA eligibility.
Prescription drug coverage.
Dental and vision benefits.
Employee Assistance Program (confidential support services).
Financial Protection & Insurance
Company-paid basic life insurance.
Optional supplemental life insurance and dependent coverage.
Short-term and long-term disability coverage.
Critical illness, accident, and pet insurance options.
Retirement & Savings
401(k) plan to support long-term financial goals. 3% automatic deferral upon eligibility; may contribute 1% to 50% of eligible earnings, either pre or post tax. Company match of 50% paid on employee contributions up to 6% of pay, payable to employees following the end of the year; immediate vesting. Additional company contribution of 4% of pay each pay day into your account; 100% vested after three (3) years of service.
Health Savings Account (HSA) and Flexible Spending Accounts (FSA) options.
Time Off & Leave
Paid Time Off (PTO): Accrual-based, increases with tenure, eligible at 90 days of employment. Full-time new employees will receive up to 12 PTO days annually; accrual based on start date and may include additional PTO based on role and/or state & local requirements. Part-time employee PTO hours are calculated based upon the standard weekly hours the employee is scheduled to work and will accrue at a minimum of 3 hours per month.
Paid Holidays: Full-time employees are eligible for 10 company-paid holidays annually, in addition to 1 mental health day, 2 floating holidays and 1 volunteer day. Holidays vary by business unit schedules. Part-time employees are eligible for 8 company-paid holidays annually, in addition to 1 mental health day and 2 floating holidays. Holidays vary by business unit schedules.
Paid leave programs, including parental, bereavement, jury duty, and military leave.
Career Growth & Education
Tuition assistance (up to $5,250 annually; 80% covered by ACG).
Professional certification support with 100% reimbursement for eligible programs.
Opportunities for career development and advancement.
Additional Perks
Complimentary AAA membership with roadside assistance and travel discounts.
Adoption assistance program.
Job Posting Period:
This position is expected to remain posted through August 28, 2026; however, it may close at any time once a qualified candidate pool is identified.
Who We Are
Become a part of something bigger.
The Auto Club Group (ACG) provides membership, travel, insurance, and financial service offerings to approximately 14+ million members and customers across 14 states and 2 U.S. territories through AAA, Meemic, and Fremont brands. ACG belongs to the national AAA federation and is the second largest AAA club in North America.
By continuing to invest in more advanced technology, pursuing innovative products, and hiring a highly skilled workforce, AAA continues to build upon its heritage of providing quality service and helping our members enjoy life’s journey through insurance, travel, financial services, and roadside assistance.
And when you join our team, one of the first things you’ll notice is that same, whole-hearted, enthusiastic advocacy for each other.
We have positions available for every walk of life! AAA prides itself on creating an inclusive and welcoming environment of diverse backgrounds, experiences, and viewpoints, realizing our differences make us stronger.
To learn more about AAA The Auto Club Group visit
Important Note:
ACG’s Compensation philosophy is to provide a market-competitive structure of fair, equitable and performance-based pay to attract and retain excellent talent that will enable ACG to meet its short and long-term goals. ACG utilizes a geographic pay differential as part of the base salary compensation program. Pay ranges outlined in this posting are based on the various ranges within the geographic areas which ACG operates. Salary at time of offer is determined based on these and other factors as associated with the job and job level.
The above statements describe the principal and essential functions, but not all functions that may be inherent in the job. This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodations will be made for otherwise qualified applicants, as needed, to enable them to fulfill these requirements.
The Auto Club Group, and all its affiliated companies, is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status.
Regular and reliable attendance is essential for the function of this job.
AAA The Auto Club Group is committed to providing a safe workplace. Every applicant offered employment within The Auto Club Group will be required to consent to a background and drug screen based on the requirements of the position.
$24 - $28 per hour
...detail-oriented and analytical Senior Revenue Cycle Specialist with strong expertise in revenue cycle processes. The ideal candidate will... ...mindset with a focus on process improvement and leveraging automation,... .... Analyze and resolve claim denials , including root cause...Process improvementSeniorClaimsFull timeRemote workMonday to Friday$80k - $98k
...,000 / Annually The Senior Total Rewards Specialist is a high-impact role for... ...accuracy, and continuous improvement to complex programs. This... ...lead Workers’ Compensation claims administration , ensuring... ...vendors to ensure smooth processes and timely case resolution...Process improvementSeniorClaimsFull timeTemporary workWork experience placementLocal areaRemote work$26 - $42 per hour
All Jobs > Settlement Specialist / Senior Settlement Specialist Settlement Specialist / Senior... ..., provider balances, subrogation claims, Medicare, Medicaid, ERISA, and other... ...Identifying recurring issues and recommending process improvements Requirements Personal injury...Process improvementSeniorClaimsFull timeWork at officeRemote work$67.81k - $89k
...Description Job Description Hi, we're Oscar. We're hiring a Senior Specialist, Process Improvement to join our Authorization Services Process Improvement... ..., and Slack ACA marketplace, provider network, claims, healthcare quality, or provider data experience...Process improvementSeniorClaimsFull timeTemporary workWork experience placementWork at officeRemote workShift work$27 - $33 per hour
...Chile, and Peru. Role Overview The Senior Specialist, Export processes orders and supports international export... ...agents, processing returns/claims/adjustments, and providing proof of... ...management to review processes and suggest improvements; provide additional reporting as...Process improvementSeniorClaimsHourly payWork at officeRemote workOverseas2 days per week- Senior Compensation & Classification Specialist Job no: 560201 Work type: Staff Location: Pomona Categories:... ...Assists in developing policy updates, process improvements, and guidelines that strengthen... ...test where an exemption is claimed; coordinates with campus counsel...Process improvementSeniorClaimsFull timeContract workFor contractorsWork experience placementWork at officeRemote work
$71.54k - $93.9k
...we're Oscar. We're hiring a Senior Specialist to join our Network... ...contracts, identifying areas for improvement and optimization. With support... ...and efficient contracting processes are in place. With input... ...internal teams such as Claims, Credentialing, and Contracting...Process improvementSeniorClaimsFull timeContract workWork experience placementRemote workWork from homeHome office$67.81k - $89k
Hi, we're Oscar. We're hiring a Senior Specialist, Issue Management to join our Network Operations... ...optimization, and implementation of processes and improvements to provider operations in support of... ...ACA marketplace, provider network, claims, healthcare quality, or provider...Process improvementSeniorClaimsFull timeTemporary workWork at officeRemote workShift work$75k - $142.5k
...Customer Service Specialist The Customer Service Specialist is... ...utilizing the Order to Cash process to drive order deliverables... ...Digest Drive Continuous Improvement: Analyze top tier customer Scorecard... ...offer or communication claiming to be from AbbVie, please do...Process improvementSeniorClaimsTemporary workWork at officeLocal areaImmediate startRemote workMonday to Friday$66.8k - $98.35k
...issues. Facilitate Key People Processes and Approachable Leadership... ...education, certifications, seniority, and location. The range listed... ...in responding to 3rd‑party claims agency/attorney charges;... ...resource policy and process improvement recommendations to the supervisor...Process improvementSeniorClaimsFull timeWork at officeLocal areaRemote workAll shiftsFlexible hours- ...Workers' Compensation Subrogation Specialist Remote Sr. Workers Compensation Subrogation... ...for managing the full subrogation process, including complex claims. Serves as a subject matter expert... ...employees, and driving process improvements to maximize recovery outcomes....Process improvementSeniorClaimsTemporary workRemote work
- ...Revenue Cycle Specialist Remote flexibility meets meaningful healthcare financial... ...the entire patient billing process to ensure accuracy and timely claim submissions. Verifies patient... ...policies. Supports revenue cycle improvements and system upgrades and collaborates...Process improvementClaimsFull timeRemote work
- ...RCM Specialist II The RCM Specialist II is an individual contributor... ...-up, posting payments, processing refunds and credits, and auditing... ...-level discrepancies and improving key revenue cycle metrics.... ...resolve unpaid or underpaid claims, denials, and aged balances...Process improvementClaimsRemote work
- ...pm Remote Summary: The Denial Coding Specialist supports the Revenue Recovery team by reviewing claims for coding accuracy and root causes for coding-related denials, as well as proposing process improvements to mitigate future denials. Working closely...Process improvementClaimsFull timeRemote workMonday to Friday
$142.38k - $175.94k
...the recruiter will track and analyze key hiring metrics to improve processes, collaborate with cross-functional teams to maintain fairness... ...reach out via LinkedIn or email with a brex.com domain. Any outreach claiming to be from Brex via other sources should be ignored.Process improvementSeniorClaimsFull timeWork at officeRemote workWork from home- ...hoursLocation: In-PersonPurpose of this position: Registration Specialist Senior provides revenue cycle services and assumes responsibility... ...payer information, along with financial responsibility, prior to claims processingMakes appropriate referrals (i.e. Patient Financial...SeniorClaimsAfternoon shift
- ...Revenue Cycle Specialist Join our culture of caring! With every... ...Under the direction of the senior revenue cycle manager, this... ...responsible for expediting claim processing by coordinating with the... ...staff education and process improvement for both ADRAD and billing...Process improvementClaimsWork from homeMonday to Friday
- ...sales-minded, and dynamic Underwriting Specialist Specialty - Merit Specialty (... ...and secure commitment in order to improve yield and retention ratios.Operates... ...Specialty partners to augment sales process. Effectively utilize Claims and Loss Control to display service...SeniorClaimsFull timeRemote workFlexible hours
- ...General Liability team is seeking a Senior Underwriting Specialist with high hazard product... ...and secure commitment in order to improve yield and retention ratios. Operates... ...partners to augment sales process. Effectively utilize Claims and Loss Control to display service...SeniorClaimsFull timeRemote workFlexible hours
- Gallagher Bassett seeks an experienced claims professional to manage workers' compensation claims with a focus on accuracy, empathy... ...degree is preferred. The position emphasizes collaboration, process improvement, and timely claim handling. #J-18808-Ljbffr Gallagher...Process improvementSeniorClaimsRemote job
- ...experienced Revenue Cycle Specialist to join our fast-... ...outstanding insurance claims in multiple dental offices... ...current revenue cycle processes. The RCS will be... ...prepare solutions to improve RCM KPI’s, including collections... ...* Anticipate needs of senior leadership and respond...Process improvementClaimsTemporary workWork at officeRemote workFlexible hours
- Gallagher Bassett is seeking a Claims Adjuster to analyze and resolve complex workers' compensation claims. The role emphasizes... ...interact with clients, manage claims with precision, and contribute to process improvements while working in a #J-18808-Ljbffr Gallagher BassettProcess improvementSeniorClaimsRemote job
$30 per hour
...Senior Program Manager We are seeking a Senior Program Manager to lead... ...management and continuous improvement in program practices Apply Agile... ...management Healthcare payer, PBM, or claims experience (nice to have) Experience in process improvement initiatives...Process improvementSeniorClaimsWork at officeRemote work$125k
...- Product Manager, Alternative InvestmentsLevel/Function: Senior Specialist, Product ManagementTitle: Product Manager, Alternative InvestmentsAbout... ...system development and remediation initiatives to ensure process improvement.Design and document product solutions, including BRDs, use...Process improvementSeniorWork at officeRemote work- West Bend Insurance Company seeks an experienced claims professional to manage complex, high-exposure claims within a specialized... ...to investigate and resolve matters, and contribute to process improvements, mentoring team members, and delivering top-tier customer service...Process improvementSeniorClaimsRemote job
- Liberty Mutual is seeking a Senior Surety Claims Specialist Manager to lead the most complex Surety and Fidelity claims. You will investigate... ...25% and collaboration with senior management to drive claims resolution and process improvements. #J-18808-Ljbffr Liberty MutualProcess improvementSeniorClaimsRemote job
- MEM Insurance is seeking a Senior Claims Representative to join our Claims team. You will manage high-exposure workers’ compensation... ...and fraud, and mentor junior adjusters while driving process improvements. You will collaborate across departments to ensure regulatory...Process improvementSeniorClaimsRemote job
- Pie Insurance is hiring a Senior Claims Adjuster in the United States. The role handles workers’ compensation claims from setup to... ...position emphasizes excellent customer service and ongoing process improvements. The candidate should have a minimum of 5 years of claims...Process improvementSeniorClaimsRemote job
- Prudential Ins Co of America is seeking a Senior Level Claim Manager to provide concierge-level service to a large client, guiding employees... ..., attorneys, and medical professionals while pursuing continuous process improvements. #J-18808-Ljbffr Prudential Ins Co of AmericaProcess improvementSeniorClaimsRemote job
$130k - $160k
...Fueled by our culture of continuous improvement, we turn ideas into impact - innovating... ...which makes everything possible.The Senior Identity Specialist is responsible for driving the strategy... ...communication, troubleshooting, process improvement, and operational support...Process improvementSeniorFull timeRemote workWork from homeWorldwideFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Senior Claims Process Improvement Specialist. Be the first to apply!



