Claims Operations Analyst

Fortegra•Jacksonville, FL

3d•Onsite

About The Position

The Claims Operations Analyst supports data-driven decision-making across claims operations through reporting, analysis, operational insights, and process optimization. The role develops and maintains recurring and ad hoc reports, analyzes claims and operational data, supports billing oversight, and assists with claims administration and vendor-management workflows. It uses reporting tools, analytics, and emerging AI-enabled technologies to improve reporting accuracy, efficiency, and visibility. The analyst partners with operational leaders and cross-functional teams to identify trends and opportunities and provide insights that support informed business decisions. Other work may include servicer maintenance and compliance tracking, monitoring operational performance, validating data integrity, and contributing to initiatives that improve operational effectiveness and scalability. The role requires strong analytical, organizational, and problem-solving skills and the ability to manage competing priorities in a fast-paced, changing environment.

Requirements

High school diploma or equivalent work experience.
At least 2–3 years of experience in a related field.
Strong analytical ability to interpret data and generate actionable insights.
Proficiency with reporting tools, data visualization platforms, and advanced Excel functionality.
Working knowledge of AI-driven analytics tools and willingness to build capabilities in emerging technologies.
Ability to translate data into executive-level insights and business recommendations.
High attention to detail and focus on data accuracy and reporting integrity.
Ability to manage multiple priorities and meet tight reporting cycles.
Strong communication skills, including presenting findings to leadership and cross-functional partners.
Critical-thinking and root-cause-analysis skills focused on performance improvement.
Strong collaboration skills and ability to influence and support decisions without direct authority.
Adaptability in a changing operational and data environment.
Commitment to continuous improvement and operational excellence through data-driven decision support.

Nice To Haves

Strong understanding of claims operations, billing processes, or insurance workflows.

Responsibilities

Develop, enhance, and maintain recurring, monthly, and ad hoc claims operations reporting.
Analyze claims, billing, and operational data to identify trends, patterns, and actionable insights for leadership.
Use AI-enabled tools and reporting capabilities to improve data accuracy, reporting efficiency, and analytical depth.
Translate complex data into executive-ready summaries, dashboards, and performance narratives.
Support billing oversight, including reconciliation, discrepancy identification, and resolution tracking.
Assist with claims-related processes such as payments, reimbursements, and vendor incident reporting.
Ensure data integrity across claims operations systems, reporting platforms, and operational datasets.
Partner with leadership and operational teams to define reporting needs and performance metrics.
Monitor operational performance indicators and surface insights to support strategic and tactical decisions.
Support servicer and vendor compliance tracking, including Certificates of Insurance and required documentation management.
Identify opportunities to automate, streamline, or enhance reporting processes as part of continuous improvement initiatives.
Support data validation, system updates, and reporting governance standards to promote consistency and reliability.