Claims Operations Coordinator
: Job Details :

The Claims Operations Coordinator, working under moderate supervision, is responsible for the day-to-day operations of the Claims Department, including applicable reporting and customer technical support. The role serves as a primary coordinator and Subject Matter Expert with respect to programs, processes, and statutory/regulatory compliance. The rol provides general administrative support such as compiling and preparing basic information, data, documentation for inclusion in reports, presentations, and communication. The role displays expertise in utilizing and implementing office practices, software, machinery, procedures, and documentation. Assists in the daily operation, management and organization of programs and processes as well as statutory and regulatory compliance reporting across the claims organization and assists with identifying, researching, creating, and maintaining solutions, processes, training, and communications related to medical and cost containment programs. Assists in completing required jurisdictional monthly, quarterly, and annual reports for claims and partners with internal resources, such as ARC, WC Underwriting, Financial Reporting, Corporate Legal and Compliance, Claims Legal, Claims Compliance, Claims IT Automation and Westfield's third-party administrator, as needed to facilitate accurate, timely and complete reporting and correction of errors. Assists Process Leader with the development, management and maintenance of all processes, programs, and vendor relationships and performance and recommends program and process improvements and assists with implementation. Assists in managing the customer, agent, claims professional, and internal business partner experience associated with all processes and communicates with new and renewal customers, often as first and only contact, to market Westfield claims protocols, programs and processes as well as provides documentation and print materials. Gathers, organizes, and analyzes data related to claims processes to assist with management of processes and creates reports and communicates results with leader for appropriate distribution. Identifies and completes verbal and written communications regarding claims programs, processes, and compliance reporting, with claims staff, internal and external business partners, customers, injured workers, agents, attorneys, regulators, project team members, claims leadership, and vendors. Performs some administrative duties for Claims Department, and other Claims teams, including, but not limited to scheduling meetings, preparing meeting recaps, maintaining memberships, requesting certified policies, coordinating training, making travel arrangements, and ordering and organizing supplies and publications. Maintains working knowledge of and utilizes standard office equipment including personal computers, appropriate software packages, and copiers. 2-4 years of experience in Insurance Claims or a related field. High School Diploma or General Education Diploma (GED) and/or commensurate experience. Westfield celebrates diversity and is committed to inclusion. All qualified applicants receive consideration for employment without regard to race, color, sex, religion, national origin, age, sexual orientation, gender identity, disability, or status as a protected veteran.