Claims AI Business Analyst

Job Summary

Driving end-to-end process transformation initiatives, the full-time remote Claims AI Business Analyst IV will leverage automation and artificial intelligence to enhance efficiency, reduce costs, and improve quality within Claims Operations.

Key responsibilities

• Establish and maintain a structured pipeline aligned to business priorities and ROI potential
• Lead cross-functional initiatives from intake through implementation and post-production stabilization
• Conduct detailed analysis of workflows to identify inefficiencies and automation opportunities

Required qualifications

• Bachelor's degree in Business, Operations, Information Systems, or a related field required
• Seven years of experience in business analysis, process improvement, or operations optimization required
• Experience with agentic AI, LLM architectures, and prompt engineering strongly preferred
• Experience in the healthcare payer industry and knowledge of claims operations preferred
• Equivalent years of relevant work experience may be accepted in lieu of required education