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 operational and claims 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, while partnering with operational leaders and cross-functional teams to identify trends and support informed business decisions.

Additional work may include servicer maintenance and compliance tracking, monitoring operational performance metrics, validating data integrity, and contributing to continuous improvement initiatives. The analyst must be organized, analytical, and adaptable, able to solve problems and manage multiple priorities in a fast-paced environment.

Requirements

• High school diploma or equivalent work experience.
• At least 2–3 years of experience in a related field.
• Strong analytical mindset and advanced ability to interpret data and generate actionable insights.
• Proficiency in reporting tools, data visualization platforms, and advanced Excel functionality.
• Working knowledge of AI-driven analytics tools and willingness to expand capabilities in emerging technologies.
• Ability to translate data into executive-level insights and business recommendations.
• High attention to detail and strong focus on data accuracy and reporting integrity.
• Ability to manage multiple priorities and deliver within tight reporting cycles.
• Strong communication skills and ability to present findings clearly to leadership and cross-functional partners.
• Critical-thinking skills focused on root-cause analysis and performance improvement.
• Strong collaboration skills and ability to influence and support decision-making without direct authority.
• Adaptability in a fast-evolving 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 to support business visibility and performance management.
• Analyze claims, billing, and operational data to identify trends, patterns, and actionable insights for leadership decision-making.
• Leverage AI-enabled tools and reporting capabilities to improve data accuracy, reporting efficiency, and analytical depth.
• Translate complex data sets into clear, executive-ready summaries, dashboards, and performance narratives.
• Support billing oversight activities, including reconciliation, discrepancy identification, and resolution tracking.
• Assist with claims-related operational processes such as payments, reimbursements, and vendor incident reporting.
• Ensure data integrity across claims operations systems, reporting platforms, and operational datasets.
• Partner cross-functionally with leadership and operational teams to define reporting needs and performance metrics.
• Monitor operational performance indicators and proactively surface insights that support strategic and tactical decisions.
• Support servicer and vendor compliance tracking, including Certificates of Insurance and required documentation management.
• Contribute to continuous improvement initiatives by identifying opportunities to automate, streamline, or enhance reporting processes.
• Support data validation, system updates, and reporting governance standards to ensure consistency and reliability.

Benefits

• Full benefit package including medical, dental, life, and vision coverage, company-paid short- and long-term disability, 401(k), tuition assistance, and more.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED