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The Claims Business Analyst is responsible for developing detailed business and functional requirements for claims processing and administration systems, as well as ensuring proper integration with downstream systems for reporting purposes. The role also includes planning and conducting User Acceptance Testing to guarantee that the systems meet the necessary specifications. Additionally, the Claims Business Analyst provides analytical support for various projects and initiatives aimed at enhancing the claims management processes within the organization.
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ROLE RESPONSIBILITIES
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- Lead requirements definitions for complex enhancements and on-going strategic initiatives.
- Identify and translate business needs into clearly defined requirements.
- Create documentation inclusive of business use cases, process / data flows, traceability matrices, and report mock-ups.
- Plan, facilitate, and conduct requirements gathering sessions, meetings, and presentations.
- Serve as the primary business analysis point of contact for assigned initiatives, ensure requirements are well understood and development teams are unblocked.
- Lead review sessions for completed business/functional requirements, with key business users focused on gaining consensus and final business approval.
- Cultivate strong professional relations within business units to thoroughly understand business needs.
- Collaborate with the development and testing teams to provide subject-matter expertise.
- Assist in troubleshooting and resolving issues when out-of-the-box functionality is leveraged.
- Ensure future solutions are efficient and effective across all business processes, while being consistent across products.
- Participate in the development and planning of the user acceptance testing activities, including test plans and scripts, based on requirements. After the planning phase, facilitate the UAT execution phase.
- Work with the business lead and project manager to obtain UAT signoff.
- Support AI‑enabled initiatives by documenting business requirements and collaborating with product, development, UX, and QA teams, as assigned.
- Provide guidance and support to less experienced business analysts. Help to improve requirements, quality, workload management, and overall delivery effectiveness.
- Proactively manage workload, priorities, and dependencies, and remain available to support additional assignments as business needs evolve.
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TECHNICAL QUALIFICATIONS
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- 7+ years of business analysis experience, with 3+ years within the space of property and casualty insurance claims. Experience with iterative and agile methodologies, with working knowledge of both SDLC and PMLC processes.
- Strong experience with the development of detailed business requirements and technical specifications.
- Proven hands-on experience with creation of business process diagrams, data rules, business requirements, and functional requirements/user stories.
- Knowledge and experience when reviewing, re-engineering, or developing IT solutions for business process/improvements automation.
- Experience operating and interfacing with business management during walkthrough, interview, presentation, and negotiation processes.
- Proven track record for creating clear, concise deliverables which reflect a deep understanding of business needs and software functionality.
- Experience supporting AI‑related or AI‑enabled initiatives is a strong plus, but not required.
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GENERAL QUALIFICATIONS
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- Proven track record for claims system implementation and support.
- Clear verbal and written skills.
- Ability to understand communication channels and can escalate appropriately.
- Experience using standard project and business tools including, Microsoft Project, Excel, PowerPoint, Project, SharePoint, UI mock-up tools, etc.
- Must be proficient with process modeling tools (e.g., Visio.)
- Experience with visualization tools is beneficial.
- Excellent problem-solving and analytical skills.
- Experience supervising small teams.
- Strong initiative with the ability to self-manage.
- Comfortable with ambiguity and able to work through challenges to complete the objectives correctly.
- Team player who works well with technical and business resources.
- Able to see tasks through to completion without significant guidance.
- Personal time-management skills and an ability to meet individual / team deadlines.
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EDUCATION REQUIREMENTS
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- B.A./B.S. Degree.
- Certified Business Analyst Professional (CBAP) is a plus but not required.
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