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Claims Operations Analyst Jobs (NOW HIRING)

Mgr, Claims Operations

Windsor, CT · Remote

$90K - $120K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

... to the analysis and resolution of very complex or sensitive claims operational issues; ability to apply new developments and methodologies to direct the improvement in efficiencies • Broad ...

Mgr, Claims Operations

Windsor, CT · Remote

$90K - $120K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

... analysis and resolution of very complex or sensitive claims operational issues; ability to apply new developments and methodologies to direct the improvement in efficiencies Broad knowledge of ...

Retailer Claims Support Manager - Operations

Camden, NJ · Hybrid

$94K - $120K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Strong data analytics, data management, and Excel experience. * Ability to function in fast-paced, high-volume work environment. * Strong working knowledge of all system applications related to ...

Claims Operations Associate

High Point, NC · On-site

$16.25 - $22/hr

Claims Associate Key Risk is looking for an enthusiastic Claims Associate professional who will be ... analysis/judgment and sound decision making with focus on attention to detail. • Ability to ...

New

Claims Finance Manager

Frisco, TX · On-site

  • Medical

  • Dental

  • Vision

This role translates claims activity into financial insights by analyzing claim costs, reimbursement trends, adjudication outcomes, reserve impacts, and operational performance. The Claims Finance ...

Intern - Claims Operations

Fort Wayne, IN · On-site

$15 - $19.75/hr

Complete several control and analytical projects * Compile list of closed claims; create, mail and file letters as necessary. * Consult with Claims Operations staff & Leadership the findings of ...

Claims Operations Associate

High Point, NC · On-site

$16.25 - $22/hr

The Claims Associate will be responsible for learning workers compensation laws and providing ... analysis/judgment and sound decision making with focus on attention to detail. • Ability to ...

Claims Operations Associate

High Point, NC · On-site

$16.25 - $22/hr

The Claims Associate will be responsible for learning workers compensation laws and providing ... analysis/judgment and sound decision making with focus on attention to detail. • Ability to ...

Claims Operations Associate

High Point, NC · On-site

$15.75 - $21.50/hr

The Claims Associate will be responsible for learning workers compensation laws and providing ... analysis/judgment and sound decision making with focus on attention to detail. • Ability to ...

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Claims Operations Analyst information

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How much do claims operations analyst jobs pay per hour?

As of Aug 19, 2026, the average hourly pay for claims operations analyst in the United States is $27.39, according to ZipRecruiter salary data. Most workers in this role earn between $20.19 and $31.49 per hour, depending on experience, location, and employer.

What does a claims operations analyst do?

A Claims Operations Analyst is responsible for reviewing, analyzing, and processing insurance claims to ensure accuracy and compliance with company policies and regulations. They work closely with claims adjusters, underwriters, and other teams to streamline workflow, identify trends, and resolve discrepancies. Their role often includes data analysis, report generation, and recommending process improvements to enhance efficiency in claims operations.

What are some common challenges faced by claims operations analysts, and how can they be managed?

Claims Operations Analysts often encounter challenges such as handling large volumes of complex claims data, ensuring accuracy under tight deadlines, and navigating ever-changing regulatory requirements. To manage these effectively, strong organizational skills, attention to detail, and proficiency with data analysis tools are essential. Collaborating closely with claims adjusters, underwriters, and IT teams also helps streamline workflows and resolve issues more efficiently. Continuous learning and staying updated on industry regulations can further support success in this role.

What are the key skills and qualifications needed to thrive as a claims operations analyst, and why are they important?

To thrive as a Claims Operations Analyst, you need strong analytical abilities, attention to detail, and a background in finance, business, or a related field, often supported by a bachelor’s degree. Familiarity with claims management software, data analysis tools like Excel, and sometimes certification in insurance or claims processing is typically required. Excellent communication, problem-solving, and organizational skills help you collaborate across teams and manage multiple priorities effectively. These competencies ensure accurate claims processing, regulatory compliance, and efficient operations in a high-volume environment.

How much do claims operations analysts make in the US?

Claims operations analysts in the US typically earn a median annual salary of around $50,000 to $70,000, depending on experience, location, and industry. Entry-level roles may start lower, while experienced analysts or those with specialized skills can earn higher salaries, often supplemented with benefits and bonuses.

How to become a claims operations analyst?

To become a claims operations analyst, candidates typically need a bachelor's degree in fields like business, finance, or insurance. Relevant skills include data analysis, attention to detail, and proficiency with claims processing software; certifications such as the Certified Claims Professional (CCP) can enhance prospects. Gaining experience through internships or entry-level roles in insurance or claims processing is also beneficial.
More about Claims Operations Analyst jobs
Infographic showing various Claims Operations Analyst job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 84% Full Time, 11% Part Time, 1% Temporary, 2% Contract, and 1% Nights. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution, with an average salary of $56,974 per year, or $27.4 per hour.

Claims Operations Manager

Mulberry Technology Inc

New York, NY • On-site

Full-time

Medical, Dental, Vision, PTO

Re-posted 4 days ago


Job description

About Mulberry

Mulberry is a venture-backed consumer product protection company modernizing the extended warranty and accidental damage protection experience for retailers and their customers.

Founded in 2018, Mulberry has raised over $35 million in venture capital funding through Series B from top-tier investors that have backed companies including Venmo, Netflix, and OpenAI. We partner with retailers across categories including furniture, appliances, electronics, and jewelry to deliver protection programs that are more transparent, more responsive, and easier for customers to actually use.

Mulberry operates at the intersection of insurance, retail, customer experience, and technology. As we expand deeper into insurtech, that combination is central to how we differentiate: pairing an AI-driven adjudication engine with the operational discipline, regulatory compliance, and world-class client experience organization required to earn the trust of customers, retailers, and partners alike.

The Role

Mulberry is hiring a Claims Operations Manager to support the Director of Operations, with broad ownership across claims adjudication quality, team management and reporting, claim cycle times, service network development, escalations, and regulatory dispute handling. Day to day, that means managing the team, keeping adjudication on track, driving claim cycle times down, and improving the workflows and systems that make the function more accurate, defensible, and scalable over time.

You'll be expected to operate with a high degree of independence. Priorities will shift, edge cases will come up, and not every process will already be fully built. You'll need to assess competing needs and make thoughtful decisions quickly and independently.

You'll also be a key point of escalation for some of the most sensitive conversations Mulberry handles, including customers, retailers, servicers, and regulators. That means communicating clearly, documenting decisions carefully, and using the patterns from those escalations to improve policy, training, workflows, and claim cycle times.

The role sits between several stakeholders, each with their own priorities and constraints. A key part of the job is reconciling those various inputs into practical, well-reasoned, and timely decisions, while remaining a strong advocate for the client experience.

Key Responsibilities1. Team Management & Reporting
  • Own day-to-day management of a blended support and claims team: staffing, scheduling, coaching, and performance management.
  • Build, maintain, and evolve operational reporting (cycle time, SLA adherence, cost-per-claim, queue health, first-contact and One-Touch Resolution rates) to give leadership real-time visibility into team and claims performance.
  • Champion One-Touch Resolution as a top-priority KPI: tracking multi-touch tickets, diagnosing root causes, and driving them down.
  • Use AI tools to improve reporting, surface trends faster, and streamline recurring tooling and analysis work.
  • Identify staffing gaps, workflow bottlenecks, and structural inefficiencies; recommend and implement fixes.
  • Present performance data to leadership on a recurring cadence.
2. Claims Adjudication Oversight
  • Ensure adjudication decisions are made in accordance with coverage definitions, exclusions, and plan terms across all product categories.
  • Monitor adherence to resolution-time targets, cost matrices, and limit-of-liability calculations.
  • Conduct regular quality audits and spot-checks of adjudication decisions; coach and retrain where decisions deviate from policy.
  • Partner with the Director of Operations to refine the adjudication framework as new fraud patterns, edge cases, and category-specific nuances emerge.
3. Claims Workflow & Process Improvement
  • Own the end-to-end claims workflow: intake, triage, adjudication, dispatch, and parts/repair/replacement procurement through to resolution.
  • Build and refine decision trees and matrices to support workflow design, IVR logic, and customer journey mapping.
  • Continuously test and refine customer-facing macros and templates: measure how clients respond to and engage with different messaging, and iterate based on results rather than intuition alone.
  • Identify and build out self-service options that let clients resolve issues without needing to escalate to an agent.
  • Partner with Engineering/Product on adjudication tooling and with CX leadership on templates, macros, and correspondence standards.
  • Build and maintain SOP documentation so process knowledge doesn't live only in people's heads.
4. Service & Repair Network Development
  • Support expansion of the servicer/repair network: identifying, vetting, and onboarding new partners across geographies and product categories.
  • Build and solidify relationships with existing service providers, including rate negotiation, SLA management, and coverage gap resolution.
  • Track servicer performance (turnaround time, quality, cost, customer satisfaction) and manage underperforming relationships.
  • Maintain a working map of servicer coverage strengths and gaps to inform network strategy.
5. Escalation, Complaint & Regulatory Dispute Management
  • Serve as first-line owner for escalated claims and customer complaints, resolving disputes directly and balancing customer experience against coverage integrity.
  • Bring keen foresight to escalation management: anticipate how complex or ambiguous inbound issues are likely to unfold and get ahead of them before they turn into formal disputes.
  • Own the response process for formal complaints filed with state Attorneys General, Departments of Financial Services (DFS), or equivalent regulatory bodies, ensuring responses are timely, accurate, and fully compliant.
  • Architect and refine customer-facing messaging (determination letters, denial language, escalation responses) to reduce the likelihood and volume of future complaints and disputes.
  • Track escalation and complaint trends and feed findings back into adjudication policy, agent training, and workflow design.
6. Cross-Functional & Compliance Leadership
  • Act as deputy to the Director of Operations across claims and support functions, with authority to make calls in their absence.
  • Partner cross-functionally with Finance, Engineering, and Partner Success on claims-related initiatives.
  • Maintain documentation and audit-readiness standards appropriate to a compliance-sensitive business.
Requirements
  • 5+ years of experience in client experience (CX) or operations, ideally within a regulated, compliance-heavy, and/or fast-paced, time-sensitive environment. Backgrounds in banking, insurance, fintech, or financial services are a strong fit.
  • Demonstrated ability to thrive in a startup environment with shifting priorities: comfortable prioritizing effectively and making sound decisions independently, without heavy oversight or established process to lean on.
  • 1 to 2 years of direct people management experience, including performance management.
  • A customer-experience obsessive mindset: track record of testing, measuring, and refining macros, templates, or customer-facing workflows based on how clients actually respond, not just how they're designed to work on paper.
  • Skilled at building decision trees and matrices to design and refine workflows, IVR logic, and customer journeys.
  • Sharp instincts for escalation management, including a demonstrated ability to spot complex or ambiguous inbound issues early and get ahead of them.
  • Experience leveraging CRMs and other data sources to build reporting, track KPIs, and drive CX and operational performance.
  • Strong written communication skills: able to draft firm, policy-grounded, professional correspondence for high-stakes or adversarial situations without sounding combative or defensive.
  • Direct experience handling escalated customer complaints or disputes.
Preferred Qualifications
  • Direct experience in product protection, extended warranty, claims management, or insurance claims specifically.
  • Exposure to formal regulatory complaint processes (state AG, DFS, CFPB, or equivalent).
  • Experience with claims/ticketing systems (e.g., Zendesk) and SQL or Excel-based reporting.
  • Experience using AI tools to improve reporting, streamline workflows, or build lightweight tooling (e.g., prompt-based automation, AI copilots for CX/ops work).
  • Experience building or improving self-service flows and IVR systems.
  • Experience with vendor or service-network management and negotiation.
  • Familiarity with benefit-based or limit-of-liability claims models.
What Success Looks Like

First 90 days: Fully ramped on current adjudication standards, claims workflow, and escalation process. Managing the day-to-day team independently. Handling escalations with minimal oversight.

6 months: Has launched at least one macro/template test-and-refine cycle with measurable impact on client engagement or resolution rate. Has identified and driven at least one meaningful workflow, IVR, or self-service improvement. Actively managing servicer relationships and contributing to network expansion. Regulatory complaint responses are accurate and consistently on time without close supervision.

12 months: Functions as a true deputy, capable of running claims operations independently for extended periods. Has measurably improved One-Touch Resolution rates and reduced escalation and complaint recurrence through improved messaging and upstream process fixes. Trusted to represent Mulberry directly in servicer negotiations and regulatory correspondence.

Compensation & Benefits
  • Competitive salary, commensurate with experience
  • Unlimited PTO
  • Comprehensive health insurance (medical, dental, and vision)
  • Equity or stock options
  • Paid company holidays
  • Remote-friendly, flexible work environment
  • Periodic in-person team experiences and offsites
  • Career growth and professional development opportunities

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