Claims Business Analyst with AI

Job Title: Claims Business Analyst / Lead BA Location: Morristown, NJ(Hybrid) Job Type: Contract Position Responsibilities: About the Role We are looking for a strong Claims Business Analyst with deep understanding of the claims adjudication function to support the development of an AI-enabled Adjudicator Workbench. This is not a typical BA role. The candidate will be expected to independently drive the project, shape requirements, work closely with business and technology stakeholders, and oversee the overall engagement. Key Responsibilities Lead requirements gathering and business analysis for the Adjudicator Workbench. Bring strong functional knowledge of the end-to-end claims adjudication process, workflows, rules, exceptions, and decision-making. Work with business stakeholders and SMEs to understand current-state processes and define future-state workflows. Translate business needs into clear BRDs, user stories, functional requirements, process flows, and acceptance criteria. Identify opportunities to leverage AI capabilities to improve adjudication efficiency, accuracy, and decision support. Work closely with product, engineering, data/AI, QA, and business teams to ensure requirements are translated effectively into the solution. Drive workshops, discussions, demos, and requirement sign-offs with stakeholders. Independently manage priorities, dependencies, risks, and open items across the engagement. Oversee the overall BA track and ensure timely delivery of requirements and project milestones. Support UAT, issue resolution, and production readiness as required. Required Skills Strong experience as a Business Analyst in the Insurance Claims domain. Deep understanding of Claims Adjudication and the role/functions of an adjudicator. Experience working on claims platforms, adjudication engines, or claims workflow solutions. Excellent verbal and written communication skills with the ability to interact confidently with business and technical stakeholders. Strong requirements elicitation, documentation, process mapping, and stakeholder management skills. Ability to work independently and own an engagement end-to-end, rather than functioning only as a requirements/documentation BA. Strong analytical and problem-solving capabilities. Experience working in Agile environments. Good to Have Experience with AI/ML-enabled insurance or claims solutions. Exposure to AI-based decisioning, automation, recommendation engines, or intelligent workflows. Experience working with claims adjudication rules, exceptions, validations, and decision support. Experience leading BA teams or workstreams. #J-18808-Ljbffr ITMC Systems, Inc