Demo

Claims Business Analyst

Compunnel Inc.
Blue Bell, PA Full Time
POSTED ON 3/26/2025
AVAILABLE BEFORE 4/24/2025

Position Title: Data Business Analyst - TPA and Carrier Clients


Summary:


This position is within the IT department with an emphasis on supporting the IT TPA and Carrier development team by ‘translating’ the needs of TPA and Carrier data requests in support of their business functions into IT technical requirements. Experience with Data Analysis and Discovery and Reporting tools are a plus.

This role offers a unique opportunity to combine domain-specific expertise in workers' compensation and P&C insurance with advanced data management and analysis skills to drive business success and client satisfaction. If you thrive in a dynamic environment and possess a passion for leveraging data to inform strategic decisions, we encourage you to apply.


In this role you will lead effort to elicit business requirements for the following core TPA and Carrier business functions:

• Claim data distribution from core systems

• Custom claim data integrations as defined by carriers and TPAs

• Onboarding / offboarding claims between TPAs

• Data needs to support compliance reporting

Key Responsibilities:

  • Data Oversight for TPA Clients and unbundled carriers: Manage and oversee data requirements and analysis for Third Party Administrator clients, ensuring accuracy, compliance, and timely reporting.
  • Leadership partner for unbundled carriers: Be a partner with the PMA carrier relations manager to build and maintain positive relationships with our unbundled carriers, especially in data.
  • Workers' Compensation and P&C Expertise: Utilize in-depth knowledge of workers' compensation and P&C insurance to address specific data needs and challenges within these domains.
  • Compliance Reporting: Develop and implement robust compliance reporting mechanisms for both carrier and unbundled carriers, ensuring adherence to regulatory standards and client requirements.
  • Claim Operations Support: Collaborate with claim operations teams to identify data requirements, streamline processes, and optimize data-driven decision-making.
  • IT Collaboration: Work closely with IT teams to leverage technology solutions, enhance data infrastructure, and implement IT-driven initiatives to support data management objectives.
  • Client Relationship Management: Function as a liaison between the organization and TPA clients, understanding their data requirements, addressing concerns, and fostering strong relationships.


Qualifications:

  • Bachelor’s degree in business administration, Computer Science, or related field.
  • Proven experience as a Business Analyst, preferably within the insurance industry.
  • Deep understanding of workers' compensation and P&C insurance principles and practices.
  • Expertise in compliance reporting for carrier and unbundled carriers.
  • Familiarity with claim operations and associated data requirements.
  • IT proficiency with a focus on BI presentation tools, data modeling, and data architecture.
  • Knowledge or experience in data catalog and data governance software, such as OvalEdge.
  • Strong analytical and problem-solving skills.
  • Excellent communication and interpersonal abilities.
  • Ability to manage multiple projects and stakeholders simultaneously.


The ideal BA will possess the following skills:

  • Business Relationship Management
  • Continuous Improvement Methodologies
  • Dynamic Leadership & Influence
  • Negotiations & Persuasion
  • Business Process Analysis
  • Staff/Team Management
  • Cross-Functional Collaboration
  • Teamwork / Team Building
  • Analytical / Conceptual Thinking
  • Technology Influencer / Enabler
  • Risk Avoidance / Management
  • Action Planning
  • Regulatory Compliance
  • Receivership/Ancillary Receiver
  • Big Picture Thinking
  • Empathy
  • Training & Development
  • Decision Making
  • Communications (multi-medium)

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