JOB DESCRIPTION

TITLECLAIMS BUSINESS ANALYST

CLASSIFICATION: NON-EXEMPT

REPORTS TO:LITIGATION MANAGER

JOB OVERVIEW:

The Claims Business Analyst is responsible for having detailed knowledge of all Claims Department workflows, all internal/external data feeds and in depth knowledge of all operational aspects of systems utilized by the Claims Department. The Claims Business Analyst will have knowledge of workers’ compensation claims case management/laws and will have solid working knowledge of the needs of all key functional groups within the department. This knowledge will be translated into in depth business requirement stories which will be used as requirement descriptions for software/system development. The focus is to help deliver an efficient and effective workflow experience to all Claims Department personnel.

This position will analyze, investigate, and make recommendations with respect to system performance, system implementation of department workflows and will require troubleshooting/problem solving skills. In addition, the Claims Business Analyst will work closely with key personnel throughout the organization to ensure that changes to Claims Systems do not negatively impact other groups within the organization. The Claims Business Analyst will work most closely with the IT Business Systems Analyst assigned to systems in the Claims Department.

The role of the Claims Business Analyst is one that requires the ability to manage complex systems and workflows from the macro level down to individual system field level detail. The position carries with it the responsibility to demonstrate strong interpersonal, negotiation and collaboration skills. It is essential that the Claims Business Analyst demonstrate curiosity and a willingness to ask tough questions. The Claims Business Analyst must be detail oriented and adept at writing business requirements that describe operations with significant depth and detail.

RESPONSIBILITIES:

  • Analyzes claims department workflows and needs to develop detailed product stories that best describe the needs of the end user.
  • Detailed knowledge of all internal/external data feeds.
  • Thorough knowledge of the claims operation and all areas that are touched by systems.
  • Problem solving and troubleshooting system issues.
  • Work closely and in a collaborative manner with the IT Business Systems Analyst.
  • Management of complex systems with a focus on key details while keeping track of the big picture.
  • Making the best decisions possible given the information/resources available with an eye to the core values of the organization.
  • Document in detail and with precision all department processes/procedures.
  • Testing solutions to ensure that they cover the desired requirements.

KEY ACCOUNTABILITIES:

  • Deliverables (Measured by the number of stories implemented and overall improvement of system performance in the Claims Department)
  • Leadership (Measured through build/no build decisions, partnership with the IT Business Systems Analyst and overall development of Claims Staff knowledge of Claims Systems)
  • Communication (Measured through the clarity of stories presented and the ease with which IT staff are able to implement solutions based on the information presented)
  • Project Management (Measured by the ability to manage multiple and competing priorities while keeping each project story on track for timely delivery)
  • Product Success (Measured by observing system performance and department ease of doing business on the system)
  • Innovation and Cost Consciousness (Measured by the ability to deliver cost effective and creative solutions to the Claims Department)

MINIMUM REQUIREMENTS:

  • Knowledge of insurance principles and laws for workers’ compensation, preferred
  • Curiosity and the willingness to ask questions
  • Strong written and verbal communication skills
  • Strong organizational skills
  • Strong negotiation skills
  • Strong analytical and interpretive skills
  • PC literate
  • Baccalaureate degree from an accredited college or university preferred
  • Requires moderate supervision with the ability to work independently, but understands the need to continuously communicate changes/updates to management.