Claims Operations Manager-Payment Accuracy

Job Description

A bit about this role:

We’re seeking a Claims Operations Manager to join an impact-oriented team focused on improving accuracy, reducing friction, and strengthening the integrity of our end-to-end processes. The team partners closely with Operations, Product, Engineering, Compliance, and Finance to identify breakdowns, uncover patterns, and maintain strong operations across the organization. This is an individual contributor role focused on investigation, root cause analysis, and process improvement.

You will work through operational queues with rigor and curiosity, blending thoughtful analysis and pattern recognition to build durable fixes to complex problems. This role is ideal for someone who thrives in ambiguity, enjoys untangling messy challenges, and is motivated by improving systems at scale. You will have the opportunity to become the go-to point person on the team, while also helping shape how we leverage AI agents and LLM-powered tools across the department.

Your Responsibilities and Impact will include:

Conduct deep, end-to-end investigations into complex operational issues, identifying root causes across people, process, policy, and technology

Work through designated queues with high attention to detail, ensuring well-supported and clearly documented determinations

Translate individual errors or anomalies into broader themes, trends, and systemic improvement opportunities

Partner cross-functionally (Operations, Product, Engineering, Compliance, Finance, etc.) to implement durable solutions

Create clear documentation, decision frameworks, and feedback loops to prevent recurrence of known issues

Use data to validate hypotheses, quantify impact, and measure improvement over time

Explore and implement AI-driven solutions (including AI agents and LLM-supported workflows) to enhance investigation quality and automate repeatable analyses

Serve as a trusted advisor and escalation point for ambiguous or high-impact operational issues

Required skills and experience:

Experience in operations, consulting, analytics, process improvement, or other complex problem-solving environments

Demonstrated strength in root cause analysis and structured problem solving

Proven ability to move from case-level detail to system-level insight

Experience identifying process gaps and driving measurable operational improvements

Strong analytical skills, including comfort working with data to identify trends and quantify impact

Excellent written and verbal communication skills, with the ability to clearly explain complex findings and recommendations

Ability to operate independently with sound judgment in ambiguous, fast-paced environments

Strong cross-functional collaboration skills and ability to influence without direct authority

Desired skills and experience:

Experience