- Participates in the identification, compilation and maintenance of detailed claim requirements and metrics that will be used to quantify expected benefits from proposed claim projects. This includes both Functional Requirements and Non-Functional Requirements.
- Assists the Claims Operations and Claims Project and Learning Managers with solution designs by clarifying & determining the solution characteristics and attributes that should define how a proposed system will work.
- Authors test cases based on traceability techniques supported by a well-executed testing plan in order to confirm all established requirements are met.
- Provides implementation support for proposed systems including the document design and publication, user training, and initial help.
- Establishes a partnership with line of business leaders and regional management to develop a clear understanding of needs and issues. Performs detailed analytical review of claims activity. Performs evaluations and pursues opportunities to control leakage, improve efficiency and reduce overall costs.
- Makes decisions and solves problems encountered in processing, recording claim details / data, and procedural operations.
- Actively participates in the development and execution of projects managed in Claims Operations for the benefit of the claims organization; assists multiple claims project managers.
- Presents results of detailed analysis and various projects to claims management.
- Collaborates with Legal, Compliance, Information Technology, Business Services Unit, Training, Field and home Office claims areas as needed.
- Actively supports the Continuous Improvement Initiative.\"
- Experience with business analysis concepts. Formal business analysis skills including experience supporting projects is strongly preferred.
- Change management experience strongly preferred.
- Demonstrated ability to analyze problems, probe for facts, identify and question assumptions, and analyze issues from different perspectives.
- Demonstrated ability to generate multiple innovative solutions.
- Knowledge of Claims processes, procedures and MCS system preferred.
- Highly motivated self-starter with an ability to effectively manage a range of tasks, people, and projects in an environment with changing priorities.
- Ability to manage and prioritize multiple activities and work in a team environment.
- Exhibit flexibility working in a fast-paced environment requiring quick response.
- Demonstrated highly effective analytical, communication, interpersonal and presentation skills.
- Detail-oriented with a heavy customer service focus.
- Certifications in Claims desirable examples being CPCU, AIC, SCLA, etc.
- Proficient in Microsoft Operating Systems as well as all Microsoft Office software.
- College degree in Business, Finance, or Computer Information Systems, preferred.
- Business Analysis Certification and/or Master s degree a plus
- 3 to 5 yrs. of experience in claims handling, claims workflow, claims systems, claims compliance or process analysis
Selective is an Equal Employment Opportunity employer. Selective maintains a drug-free workplace.
Associated topics: analyze, business analyst, business finance, financial analyst, financial reporting analyst, government, investment fund, legal, market, monitor