Claims Operations Manager (Systems & AI)

Allied Public Adjusters•Los Angeles, CA

3h•$140,000 - $160,000•Remote

About The Position

The Claims Operations Manager connects the claims team with its technology and designs, builds, and measures the systems that support claims work. The role owns claims workflows, the in-house Claimore platform, reporting and audits, and AI tools used by the team. It works with the Director of Claims, who defines standards and coaches the team, and with the Chief Growth Officer and other stakeholders. The manager serves as Claimore product owner, setting its roadmap and backlog and coordinating delivery with a vendor development team. The role builds dashboards, automated audits, reports, and AI tools, maintains the claims knowledge base, and looks for additional processes to automate. It also runs a weekly review with claims leadership and spends one week on site each quarter shadowing teams. As the function expands, the position may grow to lead operations managers and could develop into a Director of Operations role. The position is remote within the Pacific, Central, or Mountain time zones, with availability during Pacific business hours (9 a.m.–6 p.m. PST). The first 30 days are in person at the company's Southern California offices, followed by one week on site each quarter. Compensation is $140,000–$160,000 base salary plus a 10% bonus.

Requirements

At least 5 years of experience as a software product owner, managing backlog, priorities, and releases directly with an in-house or vendor development team.
Experience designing and operating workflows, including redesigning a process so its resulting data is complete and reliable.
Ability to build dashboards and reports from raw data using Power BI, SQL, Excel, or AI tools such as Claude.
Experience designing and running audits, compliance reviews, or quality programs for detailed files or processes.
Demonstrated hands-on AI building experience, such as creating a tool, workflow, agent, or knowledge base with tools such as Claude.
Strong project management skills and ability to keep developers and stakeholders on plan.
Clear writing and presentation skills, including ability to run meetings with an agenda and pre-read.
Self-directed and responsive in a remote role, maintaining a steady cadence with colleagues and stakeholders.
Availability during Pacific business hours, 9 a.m.–6 p.m. PST.

Nice To Haves

Experience in or around property insurance claims and working knowledge of the claim lifecycle and its terminology.
Experience with a system rollout or data migration, including understanding issues that can arise after go-live.

Responsibilities

Design and update claims workflows across onboarding, client relationships, carriers, vendors, legal, estimating, and contents work.
Configure claim workflows from signing through settlement, including stages, handoffs, triggers, and SLA timers.
Translate stakeholder requests into defined solutions or backlog items.
Design, run, and maintain file audits, including 45-day audits, submission timing, call and email logging, and file handling.
Track submissions, collections, cycle time, caseload by adjuster tier, and audit scores.
Turn claims KPIs and outcomes into automated scorecards and dashboards for the department, pods, and adjusters.
Own the claims numbers reported to company leadership and keep them consistent across reports.
Combine data from Claimore and other systems into a view that uses Claimore as the source of truth, and improve it as claim volume grows.
Own Claimore's roadmap and backlog, prioritize development work, communicate deadlines and delivery, accept releases, and check vendor invoices against delivered work.
Build dashboards, automated audits, and reports using AI tools such as Claude, Power BI, and Excel.
Build and maintain the Claude-based Claims AI knowledge base, structuring and updating its content and incorporating it into the team's work.
Identify and automate other processes, including ordering aerial measurements and material testing and tracking collections.
Run a weekly review with the Director of Claims and Chief Growth Officer, including an agenda and pre-read covering shipped work, audit findings, and next steps.
Make Claimore or workflow changes that do not require retraining; align with the Director of Claims before changes that do.
Review the Director of Claims' SOPs and flag steps the system cannot track.
Spend one week on site each quarter shadowing the teams that use the systems and workflows.
As the function expands beyond three pods, hire and lead operations managers responsible for audits and exceptions for new pods.