{"id":3108095,"url":"https://alion.io/job/davies-group-operations-specialist","title":"Operations Specialist","company":{"id":672845,"name":"Davies Group","domain":"davies-group.com","url":"https://alion.io/company/davies-group","size_band":"5000+","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Pinpoint","truth_index":{"grade":"A","score":100,"open_postings":20,"ghost_share":0,"stale_share":0,"repost_share":0.05,"time_to_fill_p50_days":14,"computed_at":"2026-10-23T05:54:15Z"}},"role":"Operations","role_family":"Operations","seniority":null,"employment_type":"full_time","work_mode":"remote","remote_scope":"stated_countries","remote_scope_basis":"board_field","remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["Santa Ana, United States"],"countries":["US"],"hiring_countries":["US"],"hiring_countries_total":1,"salary":{"min":25,"max":32,"currency":"USD","period":"hour","gross":null,"usd_annual":64000},"salary_estimate":null,"experience_years_min":null,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"Microsoft Office","optional":false},{"name":"Telegram","optional":false}],"status":"live","first_seen_at":"2026-10-21T19:54:54Z","employer_posted_date":"2026-10-21","last_verified_at":"2026-10-24T02:22:59Z","board_verified":true,"closed_at":null,"days_open":2,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":2},"description":"Our Story\nImagine being part of a team that’s not just shaping the future but actively driving it. At Davies North America, we’re at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors.\n\nThe Operations Specialist is a client-facing role responsible for claims support. This position serves as a key liaison among the carrier, underwriting teams, claim handlers, and management to ensure the timely and accurate exchange of information, adherence to program requirements, and maintenance of operational standards.\nThe Operations Specialist plays an integral role in carrier communications, reporting, document management, program guideline maintenance, and quality assurance. This position helps ensure that carrier requirements are consistently communicated and implemented, claim data remains accurate and complete, and operational efficiencies are maintained across the program.\nKey Responsibilities\nCarrier & Client Communications\nServe as a primary operational point of contact for carrier representatives, underwriters, and other program stakeholders.\nCoordinate with the carrier’s underwriting teams to obtain risk codes, policy information, classifications, bordereau data, and other information required for accurate claim reporting.\nCommunicate with the carrier as claims are received and follow up promptly when information or documentation is incomplete.\nFacilitate timely communication among the carrier, management, and claim handlers regarding program requirements, data needs, and operational issues.\nClaims Data Management\nReview newly received claims and ensure required claim information is obtained and accurately entered into the claims management system.\nRetrieve policies, claim documents, and related materials from the carrier’s portal or other designated systems.\nOrganize, upload, and maintain documents within the claims management system in a clear and consistent manner.\nMonitor claim data for accuracy and completeness and follow up on missing or inconsistent information.\nProgram Administration\nMaintain and update program guidelines, workflows, reference materials, and operating procedures.\nWork with the carrier and claim handlers to ensure carrier requirements and procedural updates are clearly communicated and consistently implemented.\nIdentify operational issues, coordinate with appropriate stakeholders, and assist in developing practical solutions.\nSupport the implementation of new reporting requirements, process changes, and program enhancements.\n Reporting & Quality Assurance\nMaintain and support key performance indicator (KPI), bordereau, and other carrier reporting requirements.\nMonitor performance against applicable reporting standards, service expectations, and program requirements.\nIdentify deficiencies, trends, or recurring issues and communicate them to management in a timely manner.\nAssist management in implementing training, updated procedures, or corrective actions when necessary.\nOperational Support\nProvide day-to-day operational assistance to claim handlers and management.\nAssist with special projects, audits, file reviews, data validation, and program-related initiatives.\nSupport workflow management and process improvement efforts designed to enhance service delivery, data quality, and claim handler efficiency.\nPerform other duties and provide additional support as needed to meet program and business requirements.\nTeam Support\nProvide Medicare Compliance support including checking eligibility and meeting reporting deadlines.\nCheck payee names in the OFAC system to clear for check issuance.\nMaintain a small pending of settled claims and report to carriers - essentially act as a file closer.\nSkills, knowledge & expertise\nRequired:\nExperience in insurance, claims administration, underwriting support, program operations, or a related field.\nWorking knowledge of insurance terminology, policy information, and claims processes.\nExcellent organizational skills, with the ability to manage multiple priorities and meet deadlines in a high-volume environment.\nStrong verbal and written communication skills, including the ability to communicate professionally with clients, underwriters, claim handlers, and management.\nHigh level of attention to detail and commitment to data accuracy and complete documentation.\nProficiency with claims management systems, Microsoft Office applications, carrier portals, and related business tools.\n Preferred:\nExperience working with delegated authority, third-party administrator (TPA), managing general agent (MGA), or carrier program business.\nFamiliarity with bordereau reporting, KPI monitoring, and insurance data management.\nExperience working directly with underwriting and claims teams.\nExperience supporting specialty insurance programs or transportation and environmental claims operations.\nEqual Employment Opportunity & Legal Notices\n Benefits\nAt Davies North America, we are dedicated to supporting the well-being and future of our qualifying employees. Our comprehensive benefits package includes:\nMedical, dental, and vision plans to support your health and that of your family\nA 401(k) plan with employer matching\nTime-off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non-exempt employees\nPaid holidays\nLife insurance and short-term and long-term disability coverage\nBenefit offerings, eligibility, and required employer contributions may vary based on role, classification, and applicable federal, state, and local laws, including those tied to an employee’s primary work location.\nWhere required by law, the Company provides paid sick leave, paid family and parental leave, and other mandated benefits in accordance with applicable state and local requirements.\nDiversity and Inclusion\nDavies is dedicated to fostering a diverse and inclusive workplace that embraces a wide range of perspectives and experiences. We believe that diversity of thought is essential for innovation and creativity, and we actively promote an environment where all voices are valued and heard.\nCompensation Transparency:\nThe salary range listed reflects the full compensation band for this role across all locations. Actual compensation will be based on factors such as skills, experience, qualifications, and geographic location, which may impact the final offer. We share ranges to remain transparent and consistent with pay equity practices.\nEssential Functions\nThe following responsibilities and expectations are considered essential to the successful performance of this role. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform these essential functions.\nMaintain regular and dependable attendance.\nBe available and able to perform job responsibilities during established work hours.\nBackground Check & Fair Chance Compliance\nAny background check or review of criminal history, if applicable to the role, will be conducted only after a conditional offer of employment and in compliance with applicable federal, state, and local laws, including fair-chance hiring requirements.\nMassachusetts Notice\n It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.\n\nAI Policy\n At Davies, we value authentic conversations and a fair candidate experience. While candidates may use AI and technology tools to prepare for interviews, we expect interview responses and assessments to reflect each individual's own experience, knowledge, and professional judgment. \n\nWe do not use sites like Facebook, Craigslist, or Telegram to recruit or interview potential employees or contractors. 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