Insurance Operations Specialist - Remote
Overview
Company Summary
If you are searching for a fulfilling place to develop your career and an opportunity to make a difference in helping others, then keep reading on. Here at AAC, we have a progressive culture; we listen to your ideas, value a work/life balance, invest in education, and we foster trust and respect for all individuals. Our exceptional comp and strong benefits include company matching 401K, medical, dental, vision and life insurance. We are looking for our future leaders, who are not only going to fill the qualifications for this job description, but who are going to exceed expectations. Be a part of a team whose mission is to provide quality, compassionate, and innovative care to adults struggling with addiction and co-occurring mental health disorders. Our purpose and passion are to empower patients, their families, and our communities by helping individuals achieve recovery and optimal wellness of the mind, body, and spirit.
Responsibilities
Job Summary:
The Insurance Operations Specialist supports AAC’s insurance and claims operations, including professional liability, general liability, workers’ compensation, employment-related matters, and other insured or potentially insured claims. This position serves as a central point of coordination for claim intake, documentation, reporting, tracking, follow-up, and communication throughout the lifecycle of a claim.
The position is responsible for the day-to-day administrative coordination of AAC’s insurance claims and serves as a central resource for maintaining accurate claim information, driving follow-up, and ensuring matters are appropriately routed and escalated.
The Insurance Operations Specialist works closely with facility leadership, Legal, Human Resources, insurance carriers, third-party administrators (TPAs), brokers, claims adjusters, and outside counsel to ensure claims are reported timely, documentation is complete, significant dates and events are tracked, outstanding requests are actively followed through to completion, and claim information remains accurate and current.
This role requires exceptional organizational skills, attention to detail, persistence, sound judgment, and the ability to proactively manage a high volume of matters with competing priorities while maintaining confidentiality and appropriately escalating significant issues.
Duties, Responsibilities and Core Competencies:
Claims Intake & Administration
- Receive and triage notices of incidents, claims, demands, lawsuits, administrative charges, and other matters that may result in an insurance claim.
- Gather initial incident reports, supporting documentation, correspondence, and other information necessary to establish and maintain complete claim files.
- Enter new claims and maintain accurate and current claim information within applicable claims management and internal tracking systems.
- Review incoming matters, gather potentially applicable insurance information, and coordinate timely reporting and tender to appropriate carriers, TPAs, and brokers, with escalation as needed.
- Maintain organized claim files and ensure appropriate documentation and correspondence are retained throughout the lifecycle of each matter.
- Maintain a centralized tracking mechanism for open claims, significant dates, requested follow-ups, mediations, hearings, settlement payment dates, reporting deadlines, and other key milestones.
- Maintain a regular follow-up cadence on open claims and outstanding requests, including unacknowledged tenders, pending coverage determinations, adjuster assignments, requested documentation, counsel updates, and other unresolved action items. Escalate matters that remain outstanding or require management attention.
- Perform periodic review of open claims to identify stale matters, incomplete records, missing status updates, unresolved action items, and claims that may be appropriate for closure.
Carrier, TPA & Counsel Coordination
- Maintain