Hybrid Business Analyst – US Insurance Claims Modernization

Posted 3 weeks ago

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About the role

  • Business Analyst leading the modernization of a legacy claims management platform for insurance claims. Bridging the gap between claims SMEs and technical engineering teams.

Responsibilities

  • Lead requirements gathering for the end-to-end claims lifecycle, transitioning from legacy systems to modern platforms.
  • Document current AS-IS workflows and pain points to define optimized TO-BE processes using Visio or BPMN.
  • Collaborate with adjusters, finance, and SIU teams to define logic for coverage verification, triage, reserves, and litigation handling.
  • Establish rules for fraud indicators, SIU referrals, and audit requirements to ensure compliance with state regulations.
  • Work with architects to determine modernization scope, including rules engine configuration, API integrations, and phased migration strategies.
  • Oversee source-to-target mapping, data quality rules, and reconciliation strategies for claims data like reserves and recoveries.

Requirements

  • 5+ years of BA experience specifically in US Insurance Claims and system workflows.
  • Proven track record in legacy system replacements or major re-platforming programs.
  • Proficiency in writing high-quality User Stories, BRDs, FRDs, and Acceptance Criteria.
  • Strong skills in AS-IS/TO-BE mapping, gap analysis, and facilitating stakeholder workshops.
  • Hands-on experience managing UAT, traceability matrices, and business validation.
  • Experience with COTS platforms like Guidewire ClaimCenter or Duck Creek Claims.
  • Familiarity with ACORD standards and insurance-specific data models.
  • Exposure to workflow engines, API-first integrations, cloud migration, and event-driven architectures.
  • Understanding of US-specific audit trails, state compliance, and segregation of duties.

Job title

Business Analyst – US Insurance Claims Modernization

Job type

Experience level

Mid levelSenior

Salary

Not specified

Degree requirement

Bachelor's Degree

Tech skills

Location requirements

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