Business Analyst - AI Solutions

Essential Duties and Responsibilities

• Work with operational business process owners and end users to develop thorough business and functional requirements.
• Analyze claims workflows and identify opportunities where AI-assisted solutions or automation may improve operational efficiency and user experience.
• Create concise and relevant project artifacts, process documentation, workflow diagrams, and business metrics related to operational needs.
• Work with Development teams to ensure requirements are understood and implemented as intended.
• Communicate with all levels of the organization including end users, operational leadership, Senior Leadership, Product Management, and Development teams.
• Function as a subject matter, process, and operational expert for claims-related workflows and business processes.
• Identify gaps in technology, processes, and operational workflows and recommend AI-assisted or automated solutions where appropriate.
• Ensure timely delivery of requirements and design documentation in line with project milestones.
• Recommend process improvements and assist with implementation planning to improve operational efficiency and reduce manual effort.
• Conduct interviews, workflow analysis, and operational investigations to support business cases and solution recommendations.
• Present findings, recommendations, and business cases to leadership for review and decision-making.
• Collaborate with training and operational teams to support rollout and adoption of new functionality.
• Analyze improvement requests and assist in determining operational value and ROI.

Qualifications

• Education / Licensing: High School Diploma or equivalent required; 2-year degree or higher preferred.
• Six Sigma certification not required; practical process improvement experience preferred.
• Required qualifications: 5+ years of experience as a Business Analyst or similar role, strong background in claims operations, claims administration systems, or TPA environments, experience gathering and documenting business and functional requirements, ability to translate operational needs into actionable development requirements, strong communication and collaboration skills, experience working in Agile environments, familiarity with AI, intelligent automation, or workflow automation concepts.
• Preferred qualifications: Experience working with Product Management and Development teams, understanding of claims workflows and operational processes, exposure to APIs, integrations, or modern software platforms.