Manager, Claims Operations

The Company  

Metropolis is an artificial intelligence company that uses computer vision technology to enable frictionless, checkout-free experiences in the real world. Today, we are reimagining parking to enable millions of consumers to just "drive in and drive out." We envision a future where people transact in the real world with speed, ease and convenience that is unparalleled, even online. Tomorrow, we will power checkout-free experiences anywhere you go to make the everyday experiences of living, working and playing remarkable - giving us back our most valuable asset, time.

The Role  

Metropolis is looking for a Manager, Claims Operations to lead and enhance the claims management processes within the organization, focusing on industries such as insurance, healthcare, or other sectors where claims are a key business function. Below is an outline of the role, key responsibilities, required skills, and qualifications for this position:

Key Responsibilities:

1. Claims Process Management:

• Oversee the end-to-end process of claims handling, ensuring that claims are processed accurately, efficiently, and in compliance with company policies and industry regulations.

• Monitor and optimize workflows to improve processing times, customer satisfaction, and cost control.

  1. Team Leadership:

• Lead and mentor a team of claims professionals (e.g., claims adjusters, analysts, and support staff).

• Provide guidance on handling complex claims or escalated issues and foster a culture of continuous improvement.

• Set performance goals, conduct regular performance reviews, and support training and development.

  1. Claims Quality Assurance:

• Implement quality assurance protocols to ensure that claims are handled in accordance with company standards and legal/regulatory requirements.

• Conduct audits and assessments of claims to identify areas for improvement and ensure compliance with industry best practices.

  1. Customer Interaction & Resolution:

• Handle customer escalations related to claims, ensuring resolution in a timely, effective, and empathetic manner.

• Work closely with customer service teams to ensure smooth communication and customer satisfaction regarding claims outcomes.

  1. Data Analysis & Reporting:

• Use data analytics to track key performance indicators (KPIs) like claims resolution times, claims accuracy, and customer satisfaction.

• Prepare and present regular reports to senior management regarding claims performance, trends, and areas for improvement.

  1. Process Improvement & Innovation:

• Identify and implement process improvements to streamline claims handling, reduce costs, and enhance efficiency.

• Keep up-to-date with industry trends, technologies, and regulatory changes that may impact claims operations.

  1. Cross-Department Collaboration:

• Collaborate with other departments such as underwriting, legal, finance, and compliance to resolve claims-related issues and ensure alignment across functions.

• Work closely with IT teams to ensure claims management systems are functioning optimally and may be involved in upgrading or implementing new claims technologies.

  1. Regulatory Compliance:

• Ensure that the claims process adheres to all relevant local, state, and federal regulations (e.g., HIPAA, GDPR, etc.) and company policies.

• Manage audits and provide necessary documentation during compliance reviews.

Skills and Qualifications:

• Leadership Skills: Strong ability to lead, motivate, and develop a high-performing team.
• Claims Expertise: In-depth knowledge of the specific claims processes, policies, and regulations related to the industry (e.g., insurance, healthcare, workers' compensation).
• Problem-Solving: Ability to resolve complex claims issues, balance customer needs with company policies, and make decisions that are both fair and in compliance with regulations.
• Analytical Skills: Proficient in analyzing claims data and performance metrics to drive decisions and process improvements.
• Communication Skills: Excellent verbal and written communication skills to interact with customers, employees, senior management, and external stakeholders.
• Attention to Detail: Strong focus on accuracy and compliance in claims processing.
• Project Management: Ability to manage multiple projects, initiatives, and deadlines simultaneously.
• Technological Proficiency: Familiarity with claims management software and tools (e.g., Guidewire, Xactware, or proprietary systems). Knowledge of automation and AI-based solutions can be a plus.
• Education: A bachelor’s degree in business, management, or a related field is typically required. Some employers may also value industry-specific certifications such as CPCU (Chartered Property Casualty Underwriter) or AIC (Associate in Claims).

Experience:

• Typically, employers seek candidates with 5+ years of experience in claims processing or claims management, including at least 2 years in a supervisory or managerial capacity.
• Industry-specific experience (e.g., health insurance, property and casualty, auto insurance) may be a prerequisite.