Claims Operations & Customer Service Team Leader
Role Purpose
The Claims Operations & Customer Service Team Leader is responsible for leading, coordinating, and supporting the daily operations of the FNOL Intake, Payments & Customer Service team to ensure high-quality service, accurate claims registration, timely processing of payments, and compliance with company policies and guidelines. The role provides coaching, guidance, and oversight to team members, while partnering with internal stakeholders to support operational efficiency and customer satisfaction.
Key Responsabilities
Lead the daily workflow of the FNOL Intake, Payments & Customer Service team, ensuring work is assigned, prioritized, and completed within established service levels.
Monitor team performance, productivity, quality, and turnaround times, taking action to address gaps and improve results.
Provide coaching, feedback, and support to team members to strengthen technical knowledge, customer service skills, and operational consistency.
Ensure claims are registered, documented, and processed accurately in accordance with company policies, procedures, and regulatory requirements.
Oversee the quality of claim notes, supporting documentation, and system entries to maintain data integrity and audit readiness.
Support the team in handling customer inquiries, claim status requests, and issue resolution in a professional and timely manner.
Coordinate with adjusters, examiners, supervisors, and other internal departments to ensure smooth claims processing and effective communication.
Identify process improvement opportunities and recommend actions to improve efficiency, service quality, and customer experience.
Prepare and review operational reports, metrics, and team updates as required.
Support training, onboarding, and development of new team members.
Ensure adherence to company standards, service expectations, and confidentiality requirements.
Perform other related duties and special projects as assigned.
Requirements
- Bachelor’s degree in Business Administration or a related field.
- Strong knowledge of claims processes and customer service operations.
- Experience using claims-related systems and databases.
- Strong interpersonal, analytical, and problem-solving skills.
- Excellent verbal and written communication skills.
- Customer-focused with a proactive and collaborative approach.
- High attention to detail and strong organizational skills.
- Ability to manage priorities, deadlines, and multiple tasks effectively.
- Proficiency in Microsoft Office applications, including Outlook, Teams, Word, Excel, and PowerPoint.
- Bilingual proficiency in English and Spanish, both written and verbal.
Experience
3-5 years of experience in claims, customer service, or related operational support roles.
Understanding of any custom Insurance suite or solution will be an added advantage.
Experience handling operational reporting is an asset.
Experience in customer service.