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Claims Business Process Analyst (Remote)

California FAIR Plan Association

Remote Full-time Posted 8d ago
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POSITION SUMMARY The Claims Business Process Analyst optimizes and modernizes claims processes to improve efficiency, accuracy, and alignment. This role analyzes workflows, identifies bottlenecks, and drives improvements by partnering with stakeholders and consultants to document gaps, define future processes, and implement solutions aligned with strategic priorities.   PRINCIPAL DUTIES & RESPONSIBILITIES * Evaluate claims business processes and identify opportunities to enhance efficiency, accuracy, and customer satisfaction. * Conduct root cause analyses to uncover operational gaps, data inconsistencies, or process bottlenecks. * Define and document “as-is” and “to-be” workflows using process mapping and related methodologies. * Collaborate with business stakeholders, to design improved end-to-end claims processes. * Translate business needs into functional process requirements for automation, system enhancement, or workflow redesign. * Work with the support partner vendor to implement fixes and enhancements to the Duck Creek Claims system. * Document requirements, perform user acceptance testing and validation during release cycles for the claims system. * Produce release notes and update the department as necessary on system changes. * Develop, standardize, and maintain claims-related business processes, procedures, and performance metrics. * Serve as a liaison between Claims and other departments to ensure process coherence, data alignment, and to enhance system capabilities (e.g. Duck Creek, OnBase). * Support Single Source of Truth initiatives ensuring consistent data usage, definitions, and reporting across systems. * Define and track key performance indicators (KPIs) to measure process effectiveness and turnaround times. * Prepare and present insights, findings, and process improvement recommendations to leadership. * Support internal and external audits with accurate process documentation and data integrity assurance. * Lead or participate in business process reengineering (BPR) and operational efficiency initiatives. * Promote continuous improvement through feedback loops, metric- driven decision making, and proactive issue resolution. * Perform any other tasks required to support the Association’s Mission, Values, and Strategic Objectives.   EDUCATION & EXPERIENCE * Bachelor’s degree or equivalent preferred. * Experience with Homeowners and Catastrophe (CAT) claims, particularly wind and fire events, preferred — with emphasis on understanding end-to-end claims workflows, dependencies, and process challenges.  * Proven experience in process management or business process improvement. * Advanced knowledge and practical application of process improvement tools and methodologies such as Lean, Six Sigma, or Business Process Management (BPM). * Experience with the Duck Creek Claims platform (or similar claims management systems) preferred. * Proficient in Microsoft Office Suite (Word, Excel, Outlook) with the ability to develop clear documentation, process visuals, and performance tracking templates. * Strong analytical and problem-solving skills. * Exceptional attention to detail and accuracy. * Excellent communication and collaboration skills, with the ability to engage effectively with internal stakeholders, consultants, and leadership.

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