Health Plan Claims Operations Manager Jobs (NOW HIRING)

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow.

At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best.

Who We Are

Strategic Comp is a leading provider of workers' compensation insurance for large employers committed to protecting their workforce. As part of Great American, we combine the strength and stability of a trusted organization with more than 150 years of history with the entrepreneurial spirit of a growing business.

Through our specialized insurance expertise and field-based service model, we build lasting partnerships and deliver exceptional results for our customers. Our culture is built on collaboration, excellence, and a shared commitment to serving our customers and one another.

Position Overview

The Claims Operations Associate I is an entry-level support role responsible for assisting with the setup, processing, and administration of workers' compensation claims. This position serves as a key member of the Claims Operations team, helping to ensure claims are accurately established, information is properly documented, and customer inquiries are addressed in a timely and professional manner. The role works closely with claims professionals and business partners while developing foundational knowledge of workers' compensation and insurance operations.

This is a remote, work-from-home position. Candidates must reside within the Pacific Time Zone and be available to work 37.5 hours a week from 8:00 a.m. to 4:30 p.m. Pacific Time, Monday through Friday.

Responsibilities

• Respond to customer, claimant, and internal inquiries via phone, email, and voicemail in a timely and professional manner.

• Set up and enter new claims while ensuring information is complete and accurate.

• Review claim submissions and documentation to identify discrepancies or missing information.

• Utilize claim management and workflow systems to track activities, manage workload, and maintain organization.

• Verify coverage information and assist with basic claim administration tasks.

• Process and support routine claim-related transactions in accordance with established procedures.

• Investigate and gather information needed to resolve straightforward questions and service requests.

• Document claim activity accurately and maintain detailed records within applicable systems.

• Assist with creating and distributing general correspondence and claim-related communications.

• Collaborate with claims professionals and operational partners to support efficient claim handling.

• Escalate non-routine or complex issues to management or senior team members for resolution.

• Maintain productivity and service standards while working in a remote environment.

• Demonstrate professionalism, accuracy, and attention to detail in all interactions and work products.

• Support special projects and perform additional duties as assigned.

Qualifications

• High school diploma or equivalent required.

• Experience in claims operations, claims processing, billing support, customer service, policy services, or a related insurance support role required.

• Workers' compensation claims experience preferred.

• Basic understanding of insurance concepts, terminology, and business processes.

• Strong verbal and written communication skills with the ability to effectively interact with internal and external customers.

• Demonstrated ability to work accurately, manage multiple priorities, and learn new systems and processes.

• Must reside within the Pacific Time Zone, be available during standard Pacific business hours, and be self-motivated in a remote work environment.

Business Unit:

Salary Range:

Benefits:

We offer competitive benefits packages for full-time and part-time employees*. Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental leave, adoption assistance, and tuition reimbursement. Full-time and eligible part-time employees also enjoy Paid Time Off and paid holidays, a 401(k) plan with company match, an employee stock purchase plan, and commuter benefits.

Compensation varies by role, level, and location and is influenced by skills, experience, and business needs. Your recruiter will provide details about benefits and specific compensation ranges during the hiring process. Learn more at http://www.gaig.com/careers.

*Excludes seasonal employees and interns.