Business & Systems Analysis * Partner with Claims leadership and staff to understand, document, and analyze current workflows, systems, and processes. * Elicit, refine, and prioritize business ...
Business & Systems Analysis * Partner with Claims leadership and staff to understand, document, and analyze current workflows, systems, and processes. * Elicit, refine, and prioritize business ...
Possesses full knowledge of phases of systems analysis as relates to configuration, but also ... At least five years of solid, diverse work experience in IT, health insurance delivery, claims ...
Possesses full knowledge of phases of systems analysis as relates to configuration, but also ... At least five years of solid, diverse work experience in IT, health insurance delivery, claims ...
Business & Systems Analysis * Partner with Claims leadership and staff to understand, document, and analyze current workflows, systems, and processes. * Elicit, refine, and prioritize business ...
Business & Systems Analysis * Partner with Claims leadership and staff to understand, document, and analyze current workflows, systems, and processes. * Elicit, refine, and prioritize business ...
Business Analyst I, II, III (Claims)
Boca Raton, FL · On-site +1
$80K - $109K/yr
Business & Systems Analysis * Partner with Claims leadership and staff to understand, document, and analyze current workflows, systems, and processes. * Elicit, refine, and prioritize business ...
Business Analyst I, II, III (Claims)
Boca Raton, FL · On-site +1
$80K - $109K/yr
Business & Systems Analysis * Partner with Claims leadership and staff to understand, document, and analyze current workflows, systems, and processes. * Elicit, refine, and prioritize business ...
Senior Healthcare Claims Integration Analyst
Englewood, CO · On-site
$113K - $132K/yr
Claims System Integration Analyst (POC Support) About Cognizant Cognizant (NASDAQ: CTSH) engineers modern businesses. We help our clients modernize technology, reimagine processes, and transform ...
Senior Healthcare Claims Integration Analyst
Englewood, CO · On-site
$113K - $132K/yr
Claims System Integration Analyst (POC Support) About Cognizant Cognizant (NASDAQ: CTSH) engineers modern businesses. We help our clients modernize technology, reimagine processes, and transform ...
Claims Analyst
Fresno, CA · Remote
$21 - $29/hr
Conducts contract review and sets rates within the claim adjudication system. * Collaborates with ... Review and analyze claims loss, expense reserves and reconcile claims reports with authorizations ...
Claims Analyst
Fresno, CA · Remote
$21 - $29/hr
Conducts contract review and sets rates within the claim adjudication system. * Collaborates with ... Review and analyze claims loss, expense reserves and reconcile claims reports with authorizations ...
Support gap analysis for existing payer systems (claims, clinical data, provider, member, authorization) to determine interoperability readiness. Solution Design & Functional Specifications . Develop ...
Support gap analysis for existing payer systems (claims, clinical data, provider, member, authorization) to determine interoperability readiness. Solution Design & Functional Specifications . Develop ...
Business Analyst
Buffalo, NY · On-site
Bring data from various policy and claims system / platforms into one confined data model by ... Analytics requirements collection with business interface. * Experience in mapping multiple data ...
Business Analyst
Buffalo, NY · On-site
Bring data from various policy and claims system / platforms into one confined data model by ... Analytics requirements collection with business interface. * Experience in mapping multiple data ...
DTS is looking for NASCO Claims Systems Analyst for our client project in Detroit, MI Job Responsibilities Engagement Description - Resource needed to support teams with project funded work with ...
DTS is looking for NASCO Claims Systems Analyst for our client project in Detroit, MI Job Responsibilities Engagement Description - Resource needed to support teams with project funded work with ...
Business Process Analyst- Claims Transformation
Cincinnati, OH · On-site +1
$58K - $78K/yr
Support initiatives including claims systems modernization, workflow tools, document management, data/analytics, and automation * Ensure business rules and operational impacts are fully defined prior ...
Business Process Analyst- Claims Transformation
Cincinnati, OH · On-site +1
$58K - $78K/yr
Support initiatives including claims systems modernization, workflow tools, document management, data/analytics, and automation * Ensure business rules and operational impacts are fully defined prior ...
Hospital Claims Processor V
$18.75 - $23.75/hr
... system (QNXT) * Good knowledge of International Classification of Diseases (ICD-9, ICD-10) and ... Demonstrated organizational, perform multiple priorities, and analytical skills with the ability to ...
Hospital Claims Processor V
$18.75 - $23.75/hr
... system (QNXT) * Good knowledge of International Classification of Diseases (ICD-9, ICD-10) and ... Demonstrated organizational, perform multiple priorities, and analytical skills with the ability to ...
Claims Processor
Portland, OR · On-site
$24 - $26/hr
Experience with reporting and data analysis related to claims * Coding or system configuration experience * Background in multi‐employer trusts or benefits administration * Experience supporting ...
Quick apply
Claims Processor
Portland, OR · On-site
$24 - $26/hr
Experience with reporting and data analysis related to claims * Coding or system configuration experience * Background in multi‐employer trusts or benefits administration * Experience supporting ...
Healthcare System Analyst
Venice, CA · On-site
$50 - $55/hr
We are seeking a Healthcare System Analyst with strong experience in payer systems and healthcare ... Claims Adjudication, Billing, Appeals, and Grievances. * Experience with Facets platform, including ...
Quick apply
Healthcare System Analyst
Venice, CA · On-site
$50 - $55/hr
We are seeking a Healthcare System Analyst with strong experience in payer systems and healthcare ... Claims Adjudication, Billing, Appeals, and Grievances. * Experience with Facets platform, including ...
Claims Adjudicator
$19/hr
Documentation Analysis: Evaluate claim documents, medical records, and benefit summaries to ... Enter claim details accurately into the claims system and maintain complete records. * Problem ...
Claims Adjudicator
$19/hr
Documentation Analysis: Evaluate claim documents, medical records, and benefit summaries to ... Enter claim details accurately into the claims system and maintain complete records. * Problem ...
Retailer Claims Support Manager - Operations
Camden, NJ · Hybrid
$94K - $120K/yr
... system configurations, Transportation, Audio Exchange Program, Added Security, Warranty Analysis ... Uses understanding of claims policies and procedures as a subject matter expert (SME) for retailers ...
Retailer Claims Support Manager - Operations
Camden, NJ · Hybrid
$94K - $120K/yr
... system configurations, Transportation, Audio Exchange Program, Added Security, Warranty Analysis ... Uses understanding of claims policies and procedures as a subject matter expert (SME) for retailers ...
... claims system across various sub-systems. * 5. Should be able to run queries and perform basic system analysis, RCA etc., * 6. Should work closely with the client and development team during the ...
... claims system across various sub-systems. * 5. Should be able to run queries and perform basic system analysis, RCA etc., * 6. Should work closely with the client and development team during the ...
Claims- Clerk
San Antonio, TX · On-site
$12/hr
... claims system with all information available for all parties involved. • Generate claim data ... analyze, explore and evaluate information. • Be able to identify a problem while also having a ...
Claims- Clerk
San Antonio, TX · On-site
$12/hr
... claims system with all information available for all parties involved. • Generate claim data ... analyze, explore and evaluate information. • Be able to identify a problem while also having a ...
Hospital Claims Processor V
Manhattan, NY · On-site
$45K - $57K/yr
... system (QNXT) * Good knowledge of International Classification of Diseases (ICD-9, ICD-10) and ... Demonstrated organizational, perform multiple priorities, and analytical skills with the ability to ...
Hospital Claims Processor V
Manhattan, NY · On-site
$45K - $57K/yr
... system (QNXT) * Good knowledge of International Classification of Diseases (ICD-9, ICD-10) and ... Demonstrated organizational, perform multiple priorities, and analytical skills with the ability to ...
Hospital Claims Processor V
Manhattan, NY · On-site
$18.75 - $23.75/hr
... system (QNXT) Good knowledge of International Classification of Diseases (ICD-9, ICD-10) and ... and analytical skills with the ability to follow through on assignments Able to work well ...
Hospital Claims Processor V
Manhattan, NY · On-site
$18.75 - $23.75/hr
... system (QNXT) Good knowledge of International Classification of Diseases (ICD-9, ICD-10) and ... and analytical skills with the ability to follow through on assignments Able to work well ...
Lead advanced analysis across FAS Member, Claims, and Finance modules; assess business objectives, evaluate system impacts, and define high-level solution approaches. * Evaluate FAS workflows ...
Lead advanced analysis across FAS Member, Claims, and Finance modules; assess business objectives, evaluate system impacts, and define high-level solution approaches. * Evaluate FAS workflows ...
Claims System Analyst information
See salary details
$14.66 - $18.05
14% of jobs
$20.07 is the 25th percentile. Wages below this are outliers.
$18.05 - $21.44
19% of jobs
The median wage is $23.67 / hr.
$21.44 - $24.83
26% of jobs
$24.83 - $28.21
9% of jobs
$29.98 is the 75th percentile. Wages above this are outliers.
$28.21 - $31.60
13% of jobs
$31.60 - $34.99
11% of jobs
$34.99 - $38.37
2% of jobs
$38.37 - $41.76
2% of jobs
$41.76 - $45.15
1% of jobs
$45.15 - $48.54
2% of jobs
$48.54 - $51.92
1% of jobs
$14
$27
$51
How much do claims system analyst jobs pay per hour?
What is a Claims System Analyst?
What is the difference between Claims System Analyst vs Claims Processor?
| Aspect | Claims System Analyst | Claims Processor |
|---|---|---|
| Required Credentials | Bachelor's degree in IT, Business, or related field; knowledge of claims software | High school diploma or equivalent; on-the-job training |
| Work Environment | Office setting, working with IT teams and claim systems | Office or remote, handling claim documentation and data entry |
| Employer & Industry Usage | Insurance companies, healthcare providers, third-party administrators | Insurance companies, healthcare providers, claims departments |
| Common Search & Comparison | Claims System Analyst vs Claims Processor |
The Claims System Analyst focuses on managing and improving claims software systems, requiring technical skills and analytical abilities. In contrast, Claims Processors handle the day-to-day processing of claims, emphasizing attention to detail and customer service. Both roles are essential in the claims industry but differ in responsibilities and skill requirements.
What are the key skills and qualifications needed to thrive as a Claims System Analyst, and why are they important?
What are some common challenges a Claims System Analyst faces when supporting system upgrades or implementations?
Full-time
Posted 9 days ago
Job description
Position Summary:
We are seeking an experienced Property & Casualty Claims Business Analyst with deep knowledge of Homeowners Insurance claim handling, ideally in Florida. This role will partner with the Claims department and development teams to document current processes, define requirements, and support the creation of a streamlined, automated work management system that enhances accuracy, compliance, and efficiency. The analyst will serve as the bridge between business stakeholders and technical teams, ensuring solutions are practical, sustainable, and aligned with business needs.
The ideal candidate is self-driven, detail-oriented, and able to work independently while engaging with stakeholders at all levels. This role requires balancing shifting priorities, managing scope changes, and driving projects to completion in a complex environment.
Essential Functions:
Business & Systems Analysis
- Partner with Claims leadership and staff to understand, document, and analyze current workflows, systems, and processes.
- Elicit, refine, and prioritize business requirements, ensuring clarity and alignment with strategic goals.
- Translate business needs into functional and technical requirements for system design and automation.
- Perform impact analysis to assess downstream effects on systems, operations, and compliance.
Process Optimization & Automation
- Identify opportunities to streamline claims processes and reduce manual intervention.
- Recommend and document process improvements aligned with regulatory compliance and industry best practices.
- Collaborate with IT and Claims teams to design, test, and implement new or enhanced system features.
Project Delivery & Stakeholder Engagement
- Lead requirement-gathering sessions, workshops, and user story creation with stakeholders who may have evolving needs.
- Maintain scope discipline while fostering collaboration, ensuring changes are well-documented and approved.
- Conduct user acceptance testing, validate solutions, and oversee smooth adoption of new workflows.
- Provide regular project updates and maintain transparent communication across teams.
Documentation & Quality Assurance
- Develop and maintain detailed documentation of workflows, requirements, and system configurations.
- Establish clear testing plans and coordinate defect resolution.
- Monitor outcomes to confirm implemented solutions meet business objectives and compliance standards.
Production Support & Issue Resolution
- Act as the escalation point for Claims-related system issues, prioritizing incidents based on impact and severity.
- Troubleshoot escalated help desk tickets, determine root cause, and work with IT/development teams to drive issues to prompt resolution.
- Ensure timely communication with stakeholders on issue status and resolution progress.
Required Education and Experience:
- Bachelor’s degree or equivalent combination of education and relevant work experience.
- Professional experience in the Property & Casualty Homeowners and/or Residential Commercial insurance industry functioning in a Claims System Business Analyst capacity, including requirements elicitation, documentation, and collaboration with technical teams to implement changes to insurance or policy administration systems.
- Proven experience analyzing business problems, troubleshooting issues, and applying logical, detail-oriented approaches to develop effective solutions with limited supervision.
- Demonstrated experience managing multiple assignments simultaneously, prioritizing work, managing scope, and driving work to completion with minimal supervision in a fast-paced, results-driven environment.
- Demonstrated experience working with cross-functional teams, business stakeholders, and technical resources, with strong written and verbal communication skills.
- Demonstrated experience of insurance claims processes, regulatory considerations, and system workflows.
Preferred Qualifications:
- 3+ years of professional experience in a Claims Business Analyst role within the Property & Casualty insurance industry.
- Experience supporting Homeowners and/or Residential Commercial lines of business for Florida and/or California risks, including familiarity with state-specific claims processes and regulatory requirements.
- Experience with Duck Creek, SugarCRM, ClickClaims, or similar claims workflow platforms.
- Familiarity with regulated environments such as Florida or California.
- Proficiency with tools such as SQL, Excel, Visio, Jira, or similar.
- Experience with process modeling, system integrations, and data analysis.
- Business Analyst certification (CBAP, CCBA) a plus.
Essential Skills:
- Ability to understand technical concepts and communicate effectively with developers and system vendors.
- Strong analytical and critical-thinking skills, with the ability to evaluate business needs and translate them into clear, well-defined requirements.
- Ability to work independently with minimal supervision while maintaining accountability for quality and timeliness of deliverables.
- Strong problem-solving skills, including the ability to research issues, identify root causes, and recommend practical solutions.
- Ability to understand complex business processes, system and process workflows, and dependencies.
- Proficiency with business analysis, documentation, and collaboration tools used to support project delivery.
- Ability to communicate confidently and effectively with executive leadership; demonstrating professionalism, clarity, and resilience.
- Strong interpersonal skills with the ability to navigate complex stakeholder dynamics and ensure alignment across departments.
Due to current business and operational considerations, we currently hire employees residing in the following states at this time: AL, AR, CA, CT, FL, GA, KY, MO, NC, NV, OH, SC, TN, TX, VA, and WI.
Work Authorization Requirement:
- This role requires permanent U.S. work authorization and does not offer employer sponsorship now or in the future.
WRM is committed to providing equal employment opportunities to all employees and applicants without regard to race, color, religion, sex, sexual orientation, gender identity or expression, national origin, disability, or veteran status. We take affirmative action to ensure that all employment decisions are based on merit, qualifications, and abilities.
Notice to Third Party Agencies: WRM does not accept unsolicited resumes from third party recruiting firms. Absent a signed Service Agreement by WRM’s Human Resources Department, WRM reserves the right to pursue and hire these candidates without financial obligation to recruiters or agencies.