Claims Workforce Specialist

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Job Summary:

This position supports the Claims Business Unit focusing on the management of incoming claims volume and workforce operations. The role will emphasize workforce forecasting and optimization, involving the creation, maintenance, and updating of reports to track real-time claim volumes to ensure equitable distribution among adjusters and develop future forecasting reporting to support the current and future staffing needs of the Claims Business Unit. Responsibilities include adjusting status based on unit calendars and claim volume tracking within Claims Center, managing holiday claim volumes, reassigning claims, and updating telephony skills as needed. Additionally, the role involves alerting relevant parties about technical issues, tracking staffing trends, and overseeing real-time traffic and service levels. Through these activities, the position aims to optimize resources, forecast staffing needs, and ensure efficient claims processing operations to support the Claims Business Units’ strategic pillars and member service.

Job Duties

• Create, maintain, and update the Claims Volume Report to track real-time claim/exposure volume based on data pulls from Claims Center, ensuring equitable monthly averages for adjusters.

• Monitor and adjust load factors and administrative functions in Claims Center based on unit calendars and claim volume tracking, handling the reassignment of overflow claims.

• Regularly update units on the status of incoming claim volume to keep everyone informed and aligned.

• Reassign claims from employees on leave or those who have departed, and handle the reassignments of unassigned Hi Marley, ESH demands, and incorrectly filed arbitrations.

• Update any skilling needed within configuration manager related to VMZO.

• Alert relevant parties about technical problems like network outages, Claims Center issues, and phone connectivity problems to ensure quick resolution.

• Track current staffing and monitor trends, managing schedule changes, vacation selection, and holiday scheduling based on current staffing and calendar.

• Maintain Workforce Management software, including agent profiles, Self-Serve capabilities, and exception setups, ensuring proper call routing by maintaining agent skill sets in ACD software.

• Overtime, holiday, and weekend hours may be required.

Qualifications

• Bachelors Equivalent combination of education and experience

• 2 or more years of experience within the Claims operations or equivalent business unit. Analytics background. Preferred

• Proficiency in Claims Center and Microsoft Office software products, including Outlook, Word, Excel and Teams required.

• Professional verbal and written communication skills required.

• Additional computer software skills such as Genesys and Tableau experience preferred.

• Professional organizational and time management skills required, as well as the ability to multitask and meet project deadlines as set by management.

The starting pay range for this position is:

Additionally, for full time positions, you will be eligible to participate in our incentive program based upon the achievement of organization, team and personal performance.

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Remarkable benefits:
•    Health coverage for medical, dental, vision
•    401(K) saving plan with company match AND Pension
•    Tuition assistance
•    PTO for community volunteer programs
•    Wellness program
•    Employee discounts

“Through dedicated employees we proudly deliver legendary service and beneficial products that provide members peace of mind and value.”

AAA is an Equal Opportunity Employer

The Automobile Club of Southern California will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance (FCIHO), the Unincorporated Los Angeles County (ULAC) regulation, and the California Fair Chance Act (CFCA).