[Remote] Claims Operations Manager (Systems & AI)

Note: The job is a remote job and is open to candidates in USA. Allied Public Adjusters is hiring a Claims Operations Manager to build and manage the workflows, claims platform, reporting, audits, and AI tools used by its claims team. The role owns Claimore’s roadmap, improves operational visibility and performance, and helps the claims operation scale with new pods.

Responsibilities

• Design and update the systems our claims team works in for ease of use, depth and accuracy, across every workflow a claim runs through: client onboarding, the client relationship, carriers, vendors, legal, and our in-house estimating and contents team
• Configure each workflow from the handoff after signing through the settlement profile, with stages, handoffs, triggers and SLA timers, so the team can follow it easily and every step can be tracked
• Translate stakeholder requests into defined solutions to build or backlog
• Design, run and maintain the audits that show whether files meet the standard, starting with the 45-day file audit, submissions within 30 days, call and email logging, and file handling
• Track submissions and how fast they go out, collections against submissions, cycle time, caseload by adjuster tier, and audit scores
• Turn the KPIs and outcomes the Director of Claims defines into automated scorecards and dashboards, for the department, every pod and every adjuster
• Own the claims numbers the company reports, so leadership and the All Hands work from one version
• Pull data from Claimore and our other systems into one view, with Claimore as the source of truth, and keep improving it as claim volume grows
• Serve as product owner of Claimore: own the roadmap and the backlog, and decide what our vendor development team builds and in what order
• Turn stakeholder input into clear requirements, prioritize them against everything else on the backlog, and keep the Director of Claims updated on deadlines and delivery
• Accept each release before it reaches the team, and check the development team's invoices against delivered work
• Build the tools yourself: dashboards, automated audits and reports, using AI tools like Claude along with Power BI and Excel. Larger Claimore features go to the development team
• Build and maintain our Claims AI, the Claude-based knowledge base our claims team works files with. The Director of Claims and the team supply what it knows; you structure it, keep it current and make it part of the team's day
• Look beyond Claimore for things to automate, from how we order aerial measurements and material testing to how we track collections
• Run a weekly review with the Director of Claims and the Chief Growth Officer, with an agenda and a pre-read: what you shipped, what the audits found, and what's next
• Change Claimore or a workflow on your own when the change doesn't require retraining. Review and align with the Director of Claims first for any changes that require retraining
• Review the SOPs the Director of Claims writes, and flag any step the system can't track
• Spend a week on site each quarter shadowing the teams who use what you build, to see what the data can't show you
• Grow the function with the pods: past three pods, hire and lead the ops managers who run audits and exceptions for the new ones. Lead well and build something reliable that scales, and the seat can grow into Director of Operations as ops expands beyond claims to growth, finance, people ops, IT and legal

Skills

• 5+ years of experience as product owner of a software product, managing the backlog, priorities and releases directly with a development team, in-house or vendor
• Has designed and run operational workflows, and redesigned a process so the data it produces is complete and reliable
• Can build dashboards and reports from raw data, in Power BI, SQL, Excel or AI tools like Claude
• Has designed and run audits, compliance reviews or quality programs on detailed files or processes
• Actively builds with AI: has made a real tool, workflow, agent or knowledge base with tools like Claude, at work or on their own time
• Strong project manager who keeps developers and stakeholders on a plan
• Writes and presents clearly, and runs meetings with an agenda and a pre-read
• Self-directed and responsive in a remote role, keeping a steady cadence with the people they depend on
• Experience in or around property insurance claims, with a working knowledge of the claim lifecycle and its terminology is ideal
• Has lived through a system rollout or data migration and seen what breaks after go-live is ideal

Benefits

• 401(k) with 3% non-elective contribution
• Health and dental insurance options
• Generous paid holidays and paid time-off policy
• Career advancement and professional development opportunities

Company Overview