Claims Support Associate

MSIG Holdings•Cincinnati, OH

About The Position

The Claims Operations Associate supports efficient claims administration through claim processing, operational support, data integrity, vendor coordination, quality assurance, stakeholder management, and continuous improvement. The role supports day-to-day claims operations to ensure accurate processing, routing, and compliance, and serves as a liaison among Claims Operations, Underwriting, Finance, Technology, business stakeholders, vendors, and automation partners to identify issues, manage exceptions, coordinate resolutions, and improve processes. It contributes to operational excellence through data quality, customer service, workflow efficiency, and adoption of automation and process enhancements.

Requirements

High school diploma or equivalent.
At least two years of experience in claims operations, insurance operations, customer service, or related administrative functions.
Strong analytical, communication, customer service, and problem-solving skills.
Proficiency with Microsoft Office applications.

Nice To Haves

Insurance industry experience.
Experience supporting process improvement, automation, or operational change initiatives.

Responsibilities

Support claim acknowledgment and related operational processing activities.
Coordinate with internal and external business partners to resolve operational issues and claim processing concerns.
Prepare reports, maintain records, and support operational tracking and reporting requirements.
Participate in special projects and other assigned duties.
Monitor claims operations workflows for processing exceptions, delays, and operational issues.
Investigate issues, determine root causes, and recommend corrective actions.
Engage Claims, Technology, vendor, and business stakeholders to facilitate issue resolution.
Communicate issue status, business impact, and resolution plans, and track issues through resolution with appropriate follow-up.
Act as a liaison between Claims, Underwriting, Finance, Operations, Technology, and external service providers.
Respond to inquiries about claims status, operational issues, exceptions, and workflow concerns.
Facilitate stakeholder communication and coordination to resolve operational challenges.
Identify and communicate operational trends, risks, process gaps, and improvement opportunities to Claims leadership.
Escalate systemic issues requiring cross-functional review, decisions, or corrective action.
Partner with business and technology teams to ensure operational requirements are understood and supported.
Coordinate stakeholder communication during process changes, automation initiatives, system enhancements, and operational transitions.
Assist in gathering business requirements and feedback about claims operations processes and technology solutions.
Coordinate setup and maintenance of vendors that provide claim-handling and claim-resolution services.
Review data and link financials for feeds ingested by TPA partners.
Maintain vendor records and support operational compliance requirements.
Provide backup support for claims-related financial transactions and operational processing activities.
Reconcile operational data and vendor reporting for accuracy and completeness.
Monitor operational performance metrics and service standards.
Support compliance with departmental procedures and operational controls.
Recommend corrective actions and process improvements based on operational findings.
Support transitions of new processes and activities, including documentation, training, and stabilization.
Partner with business, technology, and vendor teams to implement process improvements and operational enhancements.
Drive continuous improvement focused on workflow efficiency, turnaround time, service quality, data accuracy, and customer experience.
Participate in testing, validation, and implementation for process improvements, automation initiatives, and system enhancements.