[Remote] Sr. Manager, Claims Operations

Note: The job is a remote job and is open to candidates in USA. Coalition, Inc. is the world's first Active Insurance provider designed to help prevent digital risk before it strikes. The Senior Manager, Claims Operations is responsible for refining and scaling the operational backbone of the claims lifecycle across Cyber and Executive Risk products, ensuring a high-performing operational structure that enhances quality, efficiency, and policyholder experience.ResponsibilitiesOwn the claims operating model and day-to-day operational enablement across the lifecycle (FNOL/intake, triage, assignment, adjustments, payments, recoveries, closure, customer-service survey data collection and analysis, and reporting)Establish and maintain claims operational policies, procedures, controls, and documentation (SOPs), including clear RACI and escalation pathsIdentify and execute continuous improvement initiatives to reduce friction, improve quality, and lower operational cost (e.g., automation, standardization, reducing rework, improving vendor workflows)Build and maintain service-level objectives (SLOs/SLAs) and operating metrics for internal teams and external partnersEstablish a framework for systematic/periodic quality checks and validation (data input, documentation, and service)Enable increased utilization of technology and automation to support improved service, quality, efficiency, and scalability of the Claims organizationOwn the overall operational process for the production and transmission of accurate, complete, and timely claims bordereaux (BDX) for carrier partnersServe as the operational point of contact for carrier partner BDX inquiries—coordinating responses, root-cause analysis, corrections, and preventive process improvementsDrive continuous improvement in data quality and reporting consistency that strengthens trust with carrier partners and supports reserving and performance insightsLead the establishment and implementation of loss funds in jurisdictions globally, including rollout planning, operational design, and ongoing governance, in collaboration with Finance and ProductOversee claims payment enablement, including invoice processing, reconciliations, and related controls to ensure accuracy, timeliness, and compliance with carrier and regulatory requirementsAct as the business owner for claims operations tooling and workflows—partnering with Product and Engineering to enhance systems, automate manual processes, and improve data captureLead operational readiness for claims handling for new products, jurisdictions, and process changesElevate claims data into a reliable, decision-driving asset for Finance, Actuarial, and leadership by improving data standards, completeness, and consistencyPartner with technology teams to explore and implement Gen-AI and advanced analytics use cases that improve productivity, insight generation, and customer experienceBuild and maintain operational controls and monitoring to support internal claims audits, carrier partner reviews, and compliance assessmentsSupport the Head of Claims in creating consistent governance across claims, including adherence to claims authority, documentation standards, and reporting controlsEnsure claims operations processes meet regulatory requirements and contractual obligations, in partnership with Legal, Compliance, Finance, and Special ProjectsMaintain audit-ready processes, documentation, and evidence to support internal and external reviewsDirectly lead, manage, and develop a team of Claims Operations Associates responsible for the organization’s operational backboneOversee the end-to-end Intake and Triage process—from monitoring FNOL queues to coordinating with forensics vendors and breach counsel—ensuring timely, accurate, and consistent handlingMaintain rigorous data quality within the claims management system, including validation of complex policy data and key operational attributesOversee the loss run process and coordinate carrier partner audits and related action items to ensure continuous alignment and complianceManage loss fund and payment workflows to ensure accurate invoice processing, reconciliations, and issue resolutionEmpower the team to serve as subject-matter experts for claims tooling, reporting, and system integrationsMaintain high-standard SOPs and leverage operational metrics to feed into a robust quality-assurance and coaching frameworkCollaborate closely with Finance, Actuarial, Data, Customer Success, Legal, Compliance, Product, and Engineering on strategic initiatives and operational roadmapsPartner with internal stakeholders to ensure seamless readiness and operational support for new products, markets, and distribution arrangementsFoster high-impact relationships with key external stakeholders—including carrier partners, TPAs, and panel law firms—to ensure seamless alignment, professional trust, and operational excellence at every touchpointSkills10+ years of progressive experience in claims operations, claims shared services, or claims transformation within P&C insurance, specialty lines, or an MGA/TPA environment5+ years of experience directly managing and scaling teams in a fast-paced environmentExperience with modern claims management systems and a track record of leading the efforts to build/optimize proprietary internal toolsDemonstrated experience building resilient operational processes and controls, with strong program management and execution skillsExperience managing external stakeholders (carriers, TPAs, vendors), including performance governance, issue resolution, and contract/obligation adherenceStrong understanding of claims data, financial flows, and reporting expectations (e.g., bordereaux/management information; reserving-related reporting)Comfort partnering with technology teams on workflow, automation, systems improvements, and data model changesExcellent written and verbal communication skills; able to translate operational details into clear executive updates and partner communicationsExperience leading and developing high-performing teams in a fast-paced, evolving environmentExperience scaling operations across multiple international jurisdictions and regulatory environments is a plusBenefits100% medical, dental and vision coverageFlexible PTO policyAnnual home office stipend and WeWork accessMental & physical health wellness programs (One Medical, Headspace, Wellhub, and more)!Competitive compensation and opportunity for advancementCompany OverviewCoalition is the world's first Active Insurance provider designed to help prevent digital risk before it strikes. It was founded in 2017, and is headquartered in San Francisco, California, USA, with a workforce of 501-1000 employees. Its website is https://www.coalitioninc.com.Company H1B SponsorshipCoalition, Inc. has a track record of offering H1B sponsorships, with 4 in 2026, 15 in 2025, 22 in 2024, 18 in 2023, 17 in 2022, 6 in 2021. Please note that this does not guarantee sponsorship for this specific role.