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Specialist, Claims Operations

Remote / Online - Candidates ideally in
Sumter, Sumter County, South Carolina, 29153, USA
Listing for: Dormont Manufacturing Co
Full Time, Part Time, Remote/Work from Home position
Listed on 2026-07-04
Job specializations:
  • Insurance
    Risk Manager/Analyst, Financial Analyst
  • Business
    Risk Manager/Analyst, Financial Analyst
Salary/Wage Range or Industry Benchmark: 50000 - 70000 USD Yearly USD 50000.00 70000.00 YEAR
Job Description & How to Apply Below

The role supports the day-to-day operational execution of A&H Claims by managing workflows, coordinating with internal and external partners, and driving consistency across intake, reporting, and process execution. The focus is on improving efficiency, data quality, and overall claims operations performance.

Responsibilities
  • Support day-to-day claims operations by tracking workflows, following up on outstanding items, and ensuring workflows are progressing as expected
  • Coordinate with internal teams and external partners to gather claim information and assist with issue resolution
  • Help manage intake and backlog by organizing incoming work and routing items appropriately
  • Review reports and data for completeness, flagging any missing or inconsistent information
  • Assist with maintaining accurate records to support reporting and audit readiness
  • Escalate issues or delays and support follow-through to resolution
  • Support process improvements by identifying efficiencies and assisting with implementation of standardized workflows
  • Provide general operational support to the Claims team as needed
Work Experience

Required:

  • 1–3 years of experience in a professional, administrative, or operational support role
  • Strong organizational skills with the ability to manage multiple tasks and follow through on details
  • Experience working with data, reports, or tracking workflows in a structured environment

Preferred:

  • Experience in medical stop loss insurance, claims, or a related industry
  • Experience working with external partners, vendors, or shared service teams
  • Familiarity with claims systems, reporting tools, or operational processes
Qualifications
  • Bachelor’s degree or equivalent combination of education and relevant work experience
  • Strong organizational, communication, and follow-up skills
  • Proficiency in Microsoft Office (Excel, Outlook, Teams) and comfort working with data and reports
  • Ability to manage multiple tasks, prioritize work, and meet deadlines in a fast-paced environment
Compensation Package

The salary range for this role is provided above. This is the national range for location(s) listed. The salary offer will be decided based on the role's complexity, its location, and the candidate’s professional background, including their education and experience. Beyond the base salary, regular full-time and part-time employees will also be eligible for QBE’s annual discretionary bonus plan based on business and individual performance.

We encourage all candidates to apply, even if their salary expectations fall outside of this range, as we are committed to finding the right fit for our team.

Benefits
  • Hybrid Working – a mix of working from home and in the office
  • 22 weeks of paid leave for family growth, with 12 weeks available to all parents on a gender-equal basis
  • Competitive 401(k) program with company match up to 8%
  • Well-being program including holistic wellbeing coaching, gym membership, confidential counselling, financial and legal advice
  • Tuition Reimbursement for professional certifications, and continuing education
  • Employee Network and Community – QBE actively supports six Employee Networks, and many ways to give back to your community
Equal Employment Opportunity Statement

QBE is committed to providing reasonable accommodation to, among others, individuals with disabilities and disabled veterans. If you need an accommodation because of a disability to search and apply for a career opportunity with QBE, please inform our Talent Acquisition team to let us know the nature of your accommodation request and your contact information.

QBE provides equal employment opportunities to applicants and employees without regard to race; color; gender; gender identity; sexual orientation; religious practices and observances; national origin; pregnancy, childbirth, or related medical conditions; protected veteran status; or disability or any other legally protected status.

Skills
  • Analytical Thinking
  • Business Process Improvements
  • Claims Settlement
  • Critical Thinking
  • Customer Service
  • Insurance Analysis
  • Insurance Claims Management
  • Insurance Policies
  • Intentional collaboration
  • Managing performance
  • Negotiation
  • Problem Solving
  • Risk Management
  • Sound Judgment
  • Stakeholder Management
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