Claims Process Analyst
Posted: 04/21/2026
Job Number: 22386
Job Description
Our client is seeking a detail-oriented Claims Process Analyst to join their Claims Payments team, supporting Property & Casualty (P&C) claims operations. This role focuses on risk identification, compliance, and process integrity to ensure claims payments are accurate, timely, and aligned with operational standards.
You will play a critical role in analyzing claims that require deeper investigation, identifying root causes of payment issues, and recommending process improvements to prevent future errors.
Key Responsibilities
- Analyze large volumes of claims data (e.G., 500–800+ claims at a time) to validate system accuracy and process effectiveness
- Conduct root cause analysis to identify whether issues stem from system defects, process gaps, or compliance risks
- Prioritize and manage backlog reports, focusing on high-impact claims and time-sensitive issues
- Partner with adjusters, claims operations, and underwriting teams to resolve payment exceptions and discrepancies
- Identify opportunities to streamline workflows, improve controls, and enhance overall process efficiency
- Develop and refine standard operating procedures (SOPs) where gaps or inconsistencies exist
- Complete required documentation, including forms, reports, and member/customer communications (letters)
- Respond to ad hoc analysis requests and provide clear, actionable insights
- Deliver summaries and recommendations to leadership, supporting continuous improvement initiatives
Required Qualifications
- Experience in Property & Casualty (P&C) claims or claims operations
- Background in claims payments, underwriting support, or financial operations within insurance
- Familiarity with claims systems such as Guidewire or similar platforms
- Strong analytical and problem-solving skills with high attention to detail
- Ability to assess and differentiate system, process, and compliance-related issues
- Experience working in fast-paced, unstructured environments with shifting priorities
- Strong written communication skills, including the ability to summarize findings and provide recommendations
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