Claims Operations Manager (Systems & AI)

Job Description

Job Description

If you love owning a system and seeing it run smoother, faster and with better data because of your work, this role is for you. Here, you'll design the workflows our claims team runs on, own the platform behind them, and build the reports and AI tools that guide the company's growth. 

At Allied Public Adjusters, our mission is a world where every property loss is settled truthfully and equitably. Since 1997, we've worked on behalf of policyholders to demand what's right by using technical expertise, field investigations, and uncompromising quality. We empower policyholders with the most skillful representation, while ensuring carriers have the information they need to do what's right. Today we're rebuilding how we handle claims around pods: player-coaches leading tiered adjusters, with dedicated estimators and attorneys, all working to one standard. 

The Claims Operations Manager is the bridge between our claims team and our technology. Our Director of Claims defines what good looks like and coaches the team. You design and build the systems that make it happen and measure it: the workflows, Claimore (our in-house claims platform), the dashboards and audits, and the AI tools the team works with.

Responsibilities  

Design the Workflows 

• Design and update the systems our claims team works in for ease of use, depth and accuracy, across every workflow a claim runs through: client onboarding, the client relationship, carriers, vendors, legal, and our in-house estimating and contents team. 
• Configure each workflow from the handoff after signing through the settlement profile, with stages, handoffs, triggers and SLA timers, so the team can follow it easily and every step can be tracked. 
• Translate stakeholder requests into defined solutions to build or backlog. 

Build the Reporting, Dashboards and Audits 

• Design, run and maintain the audits that show whether files meet the standard, starting with the 45-day file audit, submissions within 30 days, call and email logging, and file handling. 
• Track submissions and how fast they go out, collections against submissions, cycle time, caseload by adjuster tier, and audit scores. 
• Turn the KPIs and outcomes the Director of Claims defines into automated scorecards and dashboards, for the department, every pod and every adjuster. 
• Own the claims numbers the company reports, so leadership and the All Hands work from one version.
• Pull data from Claimore and our other systems into one view, with Claimore as the source of truth, and keep improving it as claim volume grows. 

Claimore Product Owner 

• Serve as product owner of Claimore: own the roadmap and the backlog, and decide what our vendor development team builds and in what order. 
• Turn stakeholder input into clear requirements, prioritize them against everything else on the backlog, and keep the Director of Claims updated on deadlines and delivery. 
• Accept each release before it reaches the team, and check the development team's invoices against delivered work. 

Build with AI 

• Build the tools yourself: dashboards, automated audits and reports, using AI tools like Claude along with Power BI and Excel. Larger Claimore features go to the development team. 
• Build and maintain our Claims AI, the Claude-based knowledge base our claims team works files with. The Director of Claims and the team supply what it knows; you structure it, keep it current and make it part of the team's day. 
• Look beyond Claimore for things to automate, from how we order aerial measurements and material testing to how we track collections. 

Leadership & Process 

• Run a weekly review with the Director of Claims and the Chief Growth Officer, with an agenda and a pre-read: what you shipped, what the audits found, and what's next. 
• Change Claimore or a workflow on your own when the change doesn't require retraining. Review and align with the Director of Claims first for any changes that require retraining. 
• Review the SOPs the Director of Claims writes, and flag any step the system can't track. 
• Spend a week on site each quarter shadowing the teams who use what you build, to see what the data can't show you. 
• Grow the function with the pods: past three pods, hire and lead the ops managers who run audits and exceptions for the new ones. Lead well and build something reliable that scales, and the seat can grow into Director of Operations as ops expands beyond claims to growth, finance, people ops, IT and legal. 

Requirements  

• 5+ years of experience as product owner of a software product, managing the backlog, priorities and releases directly with a development team, in-house or vendor.
• Has designed and run operational workflows, and redesigned a process so the data it produces is complete and reliable. 
• Can build dashboards and reports from raw data, in Power BI, SQL, Excel or AI tools like Claude. 
• Has designed and run audits, compliance reviews or quality programs on detailed files or processes. 
• Actively builds with AI: has made a real tool, workflow, agent or knowledge base with tools like Claude, at work or on their own time.
• Strong project manager who keeps developers and stakeholders on a plan. 
• Writes and presents clearly, and runs meetings with an agenda and a pre-read. 
• Self-directed and responsive in a remote role, keeping a steady cadence with the people they depend on. 
• Experience in or around property insurance claims, with a working knowledge of the claim lifecycle and its terminology is ideal.
• Has lived through a system rollout or data migration and seen what breaks after go-live is ideal.

Results  

• Every claim step from signing through settlement is tracked in Claimore, and leadership can see where any file stands without asking an adjuster.
• The claims team works files with the Claims AI every day, and it stays current.
• Audits of claim and legal files run on schedule without manual pulls, and every finding ends as a system fix or a coaching item, never as the same report next month.
• Every adjuster and pod has an automated scorecard, the Director of Claims and the Chief Growth Officer make their weekly decisions from your dashboards, and the company's claims numbers come from one source.
• Claimore has one roadmap and one owner, the development team builds what the standard needs, and every invoice matches delivered work.
• Audit scores and on-time submissions rise quarter over quarter, toward 90% on the 45-day audit.
• Each new pod launches with its workflows, scorecards and dashboards live on day one. 

Logistics  

• Location: Remote within the Pacific, Central, or Mountain time zones. 
• Travel: Your first 30 days in person at our Southern California offices, then one week on site each quarter. 
• Schedule: Available during Pacific business hours of 9-6 PST. 

Salary  

• $140,000 - $160,000 base + 10% bonus 

Benefits  

• 401(k) with 3% non-elective contribution 
• Health and dental insurance options 
• Generous paid holidays and paid time-off policy 
• Career advancement and professional development opportunities 

Our Core Values: We Show Up with G.R.I.T.  

• Go-Getters: We pursue truth and fairness with rigor and expertise. We are proactive, responsive, and committed to professional service. 
• Relationship Builders: We nurture relationships based on mutual respect, challenging insurers when we must and helping them when we can, all in the spirit of resolving claim matters fairly. 
• Intelligent Experts: We work to achieve mastery of our respective crafts, trusting our teammates to do the same. By focusing on core competencies, we create a team stronger than the sum of its parts. 
• Truth Champions: We pursue truth above all else. To champion our clients' interests most effectively, we seek precisely what is owed, nothing more, and absolutely nothing less. 

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.