Business Analyst – US Insurance Claims Modernization

We are seeking an experienced Business Analyst with deep expertise in US insurance claims to lead the modernization of a legacy claims management platform.

This role is critical in bridging the gap between claims Subject Matter Experts (SMEs) and technical engineering teams.

You will drive discovery, document target-state processes, and oversee the transformation from initial First Notice of Loss (FNOL) through to final claim closure.

Responsibilities:
• Lead requirements gathering for the end-to-end claims lifecycle, transitioning from legacy systems to modern platforms.
• Document current AS-IS workflows and pain points to define optimized TO-BE processes using Visio or BPMN.
• Collaborate with adjusters, finance, and SIU teams to define logic for coverage verification, triage, reserves, and litigation handling.
• Establish rules for fraud indicators, SIU referrals, and audit requirements to ensure compliance with state regulations.
• Work with architects to determine modernization scope, including rules engine configuration, API integrations, and phased migration strategies.
• Oversee source-to-target mapping, data quality rules, and reconciliation strategies for claims data like reserves and recoveries

Required Experience:
• 5+ years of BA experience specifically in US Insurance Claims and system workflows.
• Proven track record in legacy system replacements or major re-platforming programs.
• Proficiency in writing high-quality User Stories, BRDs, FRDs, and Acceptance Criteria.
• Strong skills in AS-IS/TO-BE mapping, gap analysis, and facilitating stakeholder workshops.
• Hands-on experience managing UAT, traceability matrices, and business validation.

Preferred Experience:
• Experience with COTS platforms like Guidewire ClaimCenter or Duck Creek Claims.
• Familiarity with ACORD standards and insurance-specific data models.
• Exposure to workflow engines, API-first integrations, cloud migration, and event-driven architectures.
• Understanding of US-specific audit trails, state compliance, and segregation of duties.

McLaren Strategic Solutions is a leading-edge global technology consulting firm, addressing critical challenges across industries such as retail, financial services, and healthcare. Integrating a powerful ecosystem of platforms with capital-efficient execution, McLaren specializes in digital transformation to help businesses optimize operations, accelerate revenue, and achieve scalable outcomes. McLaren’s expertise spans the development of customer-centric applications, modernizing systems for cost-effectiveness and security, and leveraging cloud scalability for future-ready architectures. With a deep commitment to operational excellence, McLaren provides comprehensive managed services, including application maintenance, cybersecurity, platform solutions, and AI-optimized operations, ensuring seamless, secure, and efficient performance.

From supply chain automation to compliance and analytics, McLaren drives measurable impact: improving workforce productivity, reducing inventory costs, and cutting technology ownership expenses. With its emphasis on automation and zero business downtime, McLaren facilitates seamless migrations from legacy systems to modern platforms, enabling organizations to harness the full potential of digital transformation. Backed by strategic partnerships and a proven delivery model, McLaren empowers clients to innovate, modernize, and achieve lasting success in today’s digital economy.

McLaren is a certified minority owned business through the NMSDC and has a mission to place more people from non-traditional backgrounds into sustainable technology careers. Through partnerships with non-profit technology programs in underserved communities and Veteran organizations, candidates transition from tech training programs into real IT careers at McLaren. Our unique recruitment policy allows us to create exceptional teams, bringing a broad spectrum of experience to our company and creating anything but a traditional consulting firm.

Visit McLaren Strategic Solutions to learn more!

Doran Jones Inc. is proud to be part of the McLaren Strategic Ventures Group.