Claims Operations Manager

The Claims Operations Manager is a key leader, coach, and escalation point for a fast-moving claims support team. This role connects day-to-day claims operations with broader functional needs, including data insights, audit accuracy, and back-end processing. This leader is responsible for driving consistent execution, improving how work gets done, and ensuring the team operates efficiently and accurately. They will also support the team in adopting new tools and evolving processes over time, with a focus on continuous improvement and scalable operations.

This role is about leadership and ownership. The Manager sets the tone for performance, accountability, and service quality while building a team culture focused on consistency, development, and continuous improvement. Success in this role comes from being proactive, willing to learn, and comfortable leading through change in a dynamic environment. A key expectation is curiosity toward new technology, including AI-enabled tools, and openness to leveraging them as part of evolving workflows.

Minimum Qualifications:

• Bachelor’s Degree or equivalent work experience.
• At least 5 years of experience in related field.
• Experience managing a team.

Primary Job Functions:

• Lead, coach, and support a team of claims associates to ensure consistent execution, strong performance, and professional growth.
• Serve as the main escalation point for complex or sensitive claims issues, ensuring timely resolution and clear communication across stakeholders.
• Monitor daily workflow, quality, and productivity to ensure operational expectations are consistently met.
• Identify trends in claims activity and team performance, and take proactive steps to address gaps and improve outcomes.
• Partner with QA, training, and other operational teams to reinforce standards, close knowledge gaps, and strengthen overall execution.
• Support continuous improvement efforts by simplifying processes, removing inefficiencies, and improving how workflows through the team.
• Leverage reporting and data to make informed decisions and guide team priorities.
• Encourage and support the use of new tools and technology, including AI-enabled solutions, with a focus on learning, adoption, and practical application.
• Ensure team members are trained, supported, and confident in their roles, systems, and evolving processes.
• Build a team environment grounded in accountability, consistency, and open communication.
• Collaborate with cross-functional partners to ensure alignment on claims handling, process updates, and operational priorities.
• Model a proactive leadership style that balances execution, development, and adaptability in a changing environment.

The above cited duties and responsibilities describe the general nature and level of work performed by people assigned to the job. They are not intended to be an exhaustive list of all the duties and responsibilities that an incumbent may be expected or asked to perform.

Skills & Competencies Required:

• Proven ability to lead, coach, and develop team members in a fast-paced operational environment.
• Strong capability in setting expectations, driving accountability, and supporting consistent team performance.
• Solid understanding of claims operations or similar workflow-driven environments with a focus on accuracy and execution.
• Ability to manage competing priorities while maintaining service levels and operational stability.
• Strong critical thinking and problem-solving skills with a practical, solution-oriented approach.
• Comfort using data and reporting to identify trends, guide decisions, and support continuous improvement.
• Interest and curiosity in new tools and technologies, including AI-enabled solutions, with a willingness to learn and apply them in day-to-day work.
• Strong communication skills with the ability to manage escalations and collaborate effectively across teams and leadership levels.
• Ability to adapt in a changing environment and lead others through process or operational shifts.
• Focus on building a culture of consistency, accountability, and continuous improvement.

Additional Information:

• Full benefit package including medical, dental, life, vision, company paid short/long term disability, 401(k), tuition assistance and more.
• Fortegra is not accepting unsolicited resumes from search firms for this position.

Job Posting Disclaimer:

Fortegra has recently been made aware of unauthorized communications regarding career opportunities by individuals not associated with Fortegra or our recruitment team. Fortegra will only contact you from the Fortegra domain address (@fortegra.com). If you receive a message from someone posing as a Fortegra recruiter via text message, WhatsApp, Telegram or other messaging platform, please report it as phishing and block the sender.

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