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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
Job type
Experience level
Salary
Not specified
Degree requirement
Tech skills
Location requirements
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