Senior Claims Operations Specialist

Senior Claims Operations Specialist

The Sr. Claims Operations Specialist is responsible for driving operational excellence within the claims function. This role focuses on improving efficiency, streamlining workflows, and optimizing processes within the insurance broker Claims Advocacy Service Model. The position works closely with the Claims Leadership Team to support strategic initiatives, provide operational insights, and implement scalable solutions that enhance productivity and effectiveness.

Supervisory Responsibilities: None

Essential Tasks:

• Analyze existing claims operations workflows to identify inefficiencies, gaps, and areas for improvement to enhance the Claims Advocacy Service Model.
• Develop, implement, and monitor process enhancements to optimize claim intake, review, and tracking.
• Collaborate closely with the Claims Leadership Team to align operational initiatives with business goals and strategic priorities.
• Partner with IT, analytics, and business teams to automate repetitive tasks, integrate technology solutions, and enhance system functionality.
• Leverage data-driven insights, KPIs, and technology solutions—including task automation and system integration—to optimize operations and drive measurable efficiency improvements.
• Develop and track key performance indicators (KPIs) to measure operational effectiveness and drive improvement initiatives.
• Assess large account engagement and identify opportunities to improve operational support and customer experience.
• Facilitate cross-functional initiatives to streamline claims processes, reduce cycle times, and improve operational accuracy.
• Support continuous improvement programs, including Lean, Six Sigma, or other operational excellence initiatives.
• Document standard operating procedures (SOPs) and best practices for claims operations.
• Assist in change management efforts to ensure smooth adoption of new tools, processes, or policies.
• Provide operational insights and recommendations to the Claims Leadership Team to guide strategic decision-making.
• Deliver training, guidance, and educational support to Account Management and Producer teams on claims processes, systems, and best practices.
• Serve as a point of contact for operational questions, ensuring timely communication and knowledge sharing with internal teams.
• Collaborate with Account Management and Producer teams to identify operational pain points and opportunities for process improvements across accounts.

Core Competencies:

• Leadership: Display leadership skills and ability to motivate fellow employees
• Ability to Analyze and Solve Problems: Skill in recognizing challenges, exploring options, and implementing effective solutions in a timely manner
• Attention to Detail: A strong focus on completing tasks and projects accurately and thoroughly
• Communication Skills: Capable of expressing ideas clearly in both verbal and written forms and engaging with various audiences
• Timely Task Completion: Ability to finish tasks and projects efficiently, managing resources and priorities effectively
• Team Collaboration: Willingness to work together with others, promoting teamwork and supporting shared goals
• Client Focus: Dedication to understanding and addressing the needs of clients and stakeholders to ensure their satisfaction
• Dependability: Acknowledgment of the importance of being present and punctual.
• Creative Thinking: Openness to suggesting new ideas and methods to improve processes and outcome
• Organizational Skills: Capability to prioritize tasks and manage multiple projects simultaneously
• Adaptability: Willingness to adjust to changing situations and priorities, showing resilience in a dynamic work environment

Experience and Education:

• Bachelor's degree in Business, Operations Management, or related field (preferred)
• 5+ years of claims operations or related experience with an insurance carrier, TPA, or agency, with a focus on efficiency, optimization, and technology enablement.
• Experience collaborating with leadership teams to implement operational initiatives.
• Experience training, educating, or communicating complex processes to internal teams.
• Experience defining, tracking, and acting on KPIs to drive operational performance.
• Experience managing or supporting large accounts or client engagement initiatives.
• Experience using process improvement methodologies (Lean, Six Sigma, Agile) is a plus.

Licensing and Credentials:

• None required

Systems:

• Proficient with Microsoft Excel, Word, PowerPoint, and Outlook
• Working knowledge of claims management systems, workflow tools, task automation platforms, and reporting dashboards

Location:

• This is an in office role in our Dallas or Fort Worth, TX office locations.
• Hybrid opportunities for qualified candidates

Physical Requirements:

• Ability to lift 25 pounds
• Repeated use of sight to read documents and computer screens
• Repeated use of hearing and speech to communicate on telephone and in person
• Repetitive hand movements, such as keyboarding, writing, 10-key
• Walking, bending, sitting, reaching and stretching in all directions
• Travel may be required approximately 10–20% of the time for team or office initiatives.

Benefits & Compensation:

• Higginbotham offers medical, dental, vision, prescription drug coverage, 401K, equity incentive plan as well as multiple supplemental benefits for physical, emotional, and financial wellbeing.
• Employee Wellness Program
• Company paid holidays, plus PTO

Notice to Recruiters and Staffing Agencies: To protect the interests of all parties, Higginbotham Insurance Agency, Inc., and our partners, will not accept unsolicited potential placements from any source other than directly from the candidate or a vendor partner under MSA with Higginbotham. Please do not contact or send unsolicited potential placements to our team members.

Applications will be accepted until the position is filled

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.