Claims Automation and Process Senior Coordinator

The Claims Automation and Process Senior Coordinator, working under limited supervision, performs a variety of Claims Automation and Process Support (CAPS) processes utilizing established procedures in a high volume, moderately complex work environment. The role is responsible for fraud detection, work quality, accuracy, and customer service related to draft reconciliation and vendor data maintenance. The role is recognized as technical subject matter experts in various functions and may also aid and train lower-level employees. The role also supports business and functional automation activities like key milestones, in scope processes current and future state, timelines, technology dependencies, roles/responsibilities between business/supplier and vendor.

• CAPS Quality - Responsible for work quality, accuracy, and customer service in multiple systems.  Performs accurate and timely research and analysis related to assigned work, including fraud detection for incoming drafts and EFT requests, draft reconciliation and vendor data maintenance, in multiple systems.  

• Customer Service - Ensures customer service excellence and work quality.  Responsible for the customer, agent and claims professional experience associated CAPS operations. 

• Ensures that issues are resolved promptly and appropriate parties are notified. 

• Communication - Maintains effective and ongoing communication and related reporting with CAPS team, claim staff, project team members, leadership, and internal/external business partners.  Provides timely and helpful information to others across the organization. 

• Work Prioritization - Prioritizes work to meet established service level agreements and performance expectations. 

• Process Improvements - Reviews workflow processes, identifies improvement opportunities, and recommends workload and process improvement suggestions to Claims Automation and Process Support (CAPS) leadership.  Assists with implementation of approved process improvements.   

• Coaching/mentoring/training - Provides subject matter expert (SME) for various CAPS functions, training, mentoring, technical assistance, and support to CAPS team and/or IT Help. 

• Vendor Relationships - Maintains positive and effective relationships with CAPS-related vendors.  

• Travels as needed in order to perform other essential functions.

High School diploma or equivalent. Five (5) years customer service or commensurate experience. Strong oral, written, and interpersonal communication skills resulting in the ability to interact with management, employees and vendors at all levels of the organization. Strong working knowledge of CAPS processes/procedures, Claim Center, JP Morgan, PeopleSoft, and other CAPS related systems. Proficient use of various core systems, office and computer equipment, and software packages, including Microsoft Office Products, such as Word/Excel/SharePoint. Attention to detail and problem-solving skills.

Automation, Business Process Improvement, Claims Processing, Claims Systems, Customer Service Management, Data Analysis and Reporting, Information Systems, Insurance Industry Knowledge, Quality Assurance, Technical Documentation, Technology Solutions