Claims Business Analyst

Claims Business Analyst - Workers Comp

Lead requirements' definitions for complex projects and multi-year strategic initiatives. Identify & 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. 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.

Technical Qualifications

7+ years of business analysis experience, with 3+ years within the space of Workers Comp Claims. Must have a clear understanding and experience with the statutory and compliance reporting requirements and best practices for multi-jurisdictional Workers' Compensation claims. Extensive experience with integrating multiple vendors needed for Workers' Compensation claim handling. Strong experience with claims management and medical bill review solutions. Experience with iterative and agile methodologies, with working knowledge of both SDLC & PMLC processes. Proven hands-on experience with creation of business process diagrams, data rules, business requirements, and functional requirements / user stories. Possess knowledge and experience when reviewing, re-engineering, or developing IT solutions for business process / improvements automation. Candidate has 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.

General Qualifications

Proven track record for Workers' Compensation system implementation and support. The candidate has clear verbal and written skills. Able 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. Possess excellent problem-solving and analytical skills. Candidate has experience supervising small teams. Possess a strong initiative with the ability to self-manage. Comfortable with ambiguity and able to work through challenges to complete the objectives correctly. The candidate is a team player who works well with technical and business resources. Able to see tasks through to completion without significant guidance. Has personal time-management skills and an ability to meet individual / team deadlines.