Claims Operations Associate - Wilkes Barre, PA (18701)

Overview Good things are happening at Berkshire Hathaway GUARD Insurance Companies.

We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers.

Our companies are all rated A+ Superior by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country.

Our vision is to be a leading small business insurance provider nationwide.

Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity.

We are always in search of talented individuals to join our team and embark on an exciting career path! Benefits: We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all.

You'll be surprised by all we have to offer! Competitive compensation Healthcare benefits package that begins on first day of employment 401K retirement plan with company match Enjoy generous paid time off to support your work-life balance plus 9 paid holidays Up to 6 weeks of parental and bonding leave Hybrid work schedule (3 days in the office, 2 days from home) Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation) Tuition reimbursement after 6 months of employment Numerous opportunities for continued training and career advancement And much more!

Responsibilities As a Claims Operations Associate, you'll assist in keeping service standards on track, ensuring regulatory and litigation workflows run smoothly, and equipping adjusters and leaders with accurate, timely operational intelligence.

What you'll do: Service compliance & QA Audit callback alerts Track call answer rates and trends Litigation & subpoenas Maintain and publish the Litigation Calendar for the Complex Unit Submit external subpoenas via approved vendors; process external subpoena responses Clinical/UR workflows Prepare Utilization Review determination responses and manage medical-records uploads Crossteam file movement Build/maintain transfer templates to move files between Complex and Lien units Coverage & Legal Ops support Draft no coverage letters in partnership with the Coverage team Review Legal Ops invoices for accuracy and policy alignment Operational overflow handling Process overflow work: adjuster alerts, ISO activity, FROI filings, and related File reviews Coordinate review schedules with leaders and insureds Standardize and collect claim summaries, ensuring completeness ahead of reviews Projects as needed Flex to support priority initiatives and stakeholders when volume or complexity spikes.

Qualifications What you'll bring:

Experience in Workers' Compensation claims operations or shared services High School Diploma / GED (required) Familiarity with subpoena workflows, litigation calendars, UR determinations, ISO ClaimSearch, and FROI filings Strong data skills (Excel/Sheets: formulas, pivot tables; comfort with dashboards/metrics) Clear, concise writingespecially for coverage letters and executive-facing summaries High ownership, organization, and followthrough across multiple teams and deadlines Proficiency with Microsoft 365 (Outlook, Teams, SharePoint); ability to learn internal systems quickly Discretion and sound judgment when handling PHI/PII and sensitive claim materials Nice to have: Exposure to CCU/EIU/Lien unit operations and California claims practices

Experience coordinating multistakeholder reviews (insureds, counsel, vendors) Basic familiarity with invoice review and coverage analysis Options Apply for this job online Apply Share Email this job to a friend Refer Sorry the Share function is not working properly at this moment.

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