Claims Enablement Specialist

📋 Description

• • Serve as the final escalation point for complex claims system and workflow issues, independently triaging, resolving, or escalating defects to IT.
• • Act as the primary subject matter expert (SME) for claims systems, providing guidance on system usage, configuration impacts, and workflow alignment while supporting the Help Desk on intricate technical issues.
• • Collaborate directly with Claims leadership to ensure business readiness for system changes by analyzing, prioritizing, and validating defects and enhancements prior to deployment.
• • Function as the key liaison between Claims, Help Desk, and IT teams, translating business needs into clear, actionable technical requirements and driving process improvements.
• • Develop, maintain, and update standard operating procedures (SOPs), troubleshooting frameworks, and knowledge resources to ensure consistent operations and effective user enablement across the claims function.
• • Translate data insights and business needs into actionable recommendations for system behavior, issue resolution, and operational efficiency.
• • Lead user acceptance testing (UAT) coordination and business validation efforts for all system changes, ensuring successful readiness for production releases.
• • Support end-to-end system rollouts and change execution, including drafting and delivering user communications and facilitating adoption of new functionality.
• • Drive continuous improvement by analyzing ticket trends, performance metrics, and user feedback to enhance system performance, training effectiveness, and operational workflows.
• • Support internal and external audits related to claims processes and system activity, ensuring compliance and accurate documentation of system usage and controls.
• • Apply advanced knowledge of commercial claims operations and property and casualty insurance terminology to diagnose systemic issues and recommend targeted solutions.
• • Utilize strong analytical and root cause analysis skills to resolve complex business and technical problems from both functional and technical perspectives.
• • Design and deliver training materials and documentation tailored to both technical and non-technical audiences to ensure clear understanding and adoption of system changes.
• • Leverage automation or AI-enabled tools to improve efficiency in claims enablement processes, where applicable.
• • Operate effectively in a fast-paced, iterative environment with multiple concurrent projects and strict deadlines, adapting to shifting priorities and emerging technologies.
• • Demonstrate strong interpersonal and conflict resolution skills when managing cross-functional stakeholder relationships and resolving operational disputes.