Claims Enablement Specialist

The Claims Enablement Specialist at Gore Mutual is a pivotal contributor to the advancement of the Claims Department's objectives, working closely with the Claims Enablement Manager to deliver and execute strategic projects and initiatives. This role is designed to drive innovation by supporting forward-thinking initiatives that enhance the claims process, serve as a multi-functional resource across all lines of business, and foster collaboration with cross-functional teams such as IT and Claims Analytics. Leveraging analytics, the specialist monitors claims metrics to identify opportunities for optimal service quality and financial efficiency. The role supports automation solutions for greater accuracy and speed in claims processing, and proactively identifies employee irritants and expense savings opportunities to continuously elevate departmental performance and deliver quality solutions.

What you will do:

• Monitor and analyze claims unit performance, collaborate with the Claims Enablement Manager to implement improvement strategies, and provide regular performance reports highlighting achievements and opportunities for growth.
• Evaluate and enhance claims processes by leveraging data-driven insights, collaborating with IT and Data teams to implement technological improvements and update procedures for greater efficiency.
• Communicate analytical insights and recommendations to a diverse range of stakeholders, foster strong cross-functional partnerships, and collaborate on effective communication strategies to support claims initiatives.
• Support project delivery and execution by collaborating with the Claims Enablement Manager and IT, identifying and addressing business challenges through data analysis, and continuously developing expertise in claims management and industry trends.
• Provide data and business case support for annual planning, identify opportunities for cost savings and improved employee and customer experience, and coordinate across business management teams to ensure effective planning and execution.
• Build and maintain processes, procedures and work instructions, maps, workflows, and other process related documents. Identify end-to-end processes to improve operational efficiencies.
• Define and document end-to-end process and narratives, identify gaps and make recommendations to enhance and improve KPI's and SLA's.
• Conduct observations with stakeholders, working through customer facing processes – analyze the processes and collect pain points.
• Gather and process data to measure the effectiveness of processes and identify process performance improvement areas.
• Maintain adequate supporting documentation i.e., detailed notes, process maps, project schedules and timelines with signoffs from the business.
• Conduct testing to ensure that documented newly designed or modified processes meet the desired objectives and are error-free. Monitor the effectiveness of updated workflows and processes.

What you need to Succeed:

• 5+ years of Claims experience preferred
• 2-3 years working in a delivery or initiatives execution role
• Strong understanding of business operations and internal policies/procedures
• Experience as a Claims specialist or people leader is an asset
• Strong stakeholder management and relationship management skills
• Financial Acumen and experience in building business cases
• Strong data analysis and advanced Excel skills
• Proficiency with Guidewire Claims Center and process mapping to optimize claims workflows
• Tactical and operational thinking applied to project and initiative implementation
• Experience in project management and supporting business case development
• Demonstrates a strong interest in leveraging Artificial Intelligence technologies to enhance business processes and drive innovative solutions.
• Lead projects and workstreams with rigor, demonstrating the ability to independently organize, align, and integrate multiple project streams into a cohesive delivery.

Hybrid: We are a hybrid company and work 2 days per week in-office. This role has the flexibility to attend either our Cambridge or Toronto office.

The expected base salary range for this position is $81,000 - $131,000. Depending on your relevant experience, skills, qualifications, market conditions and business needs, base compensation may vary. You have the potential to earn more through Gore Mutual's discretionary bonus program which gives you an opportunity to increase your total compensation, provided the business meets its performance targets and you meet your individual goals.

Please note: This range reflects the expected base salary for this role but may not represent the full compensation range for all experience and skill levels. During the recruitment process, we will discuss and consider how your unique qualifications align with the broader range for this position.

Gore Mutual is proud to offer a comprehensive total rewards package which includes extended health and dental benefits, disability insurance, retirement plan matching, paid time off, recognition and perk programs.