POSITION SUMMARY
The Claims Business Process Analyst plays a key role in optimizing and modernizing the end-to-end claims business processes. This role focuses on improving process efficiency, operational accuracy, and cross-departmental alignment. The role will analyze, design, and implement enhanced workflows, identify process bottlenecks and inefficiencies, and drive operational improvements.
Working closely with internal stakeholders and external consultants, this role serves as a business process steward who is responsible for understanding current workflows, documenting gaps, defining future-state processes, and helping to implement solutions that align with strategic priorities and modernization initiatives.
This position requires strong analytical and problem-solving skills, a solid understanding of claims operations, and the ability to translate business challenges into actionable process and technology improvements.
PRINCIPAL DUTIES & RESPONSIBILITIES
- Evaluate existing claims business processes and identify opportunities to enhance efficiency, accuracy, and customer satisfaction.
- Conduct root cause analyses to uncover operational gaps, data inconsistencies, or process bottlenecks.
- Define and document “as-is” and “to-be” workflows using process mapping and related methodologies.
- Collaborate with business stakeholders, to design improved end-to-end claims processes.
- Translate business needs into functional process requirements for automation, system enhancement, or workflow redesign.
- Support implementation of new workflows, ensuring proper change management and training. Develop, standardize, and maintain documentation for claims-related business processes, procedures, and performance metrics.
- Ensure that claims processes adhere to company policies, best practices, and all state/federal regulatory requirements.
- Serve as a liaison between Claims and other departments to ensure process coherence and data alignment.
- Support Single Source of Truth (SSOT) initiatives to ensure consistent data usage, definitions, and reporting across systems.
- Partner with technology teams to evaluate and enhance system capabilities (e.g., Duck Creek, OnBase, ADLS, Snowflake).
- Define and track key performance indicators (KPIs) to measure process effectiveness and turnaround times.
- Prepare and present insights, findings, and process improvement recommendations to leadership.
- Support internal and external audits with accurate process documentation and data integrity assurance.
- Lead or participate in business process reengineering (BPR) and operational efficiency initiatives.
- Promote a culture of continuous improvement through feedback loops, metrics-driven decision making, and proactive issue resolution.
EDUCATION & EXPERIENCE
- Bachelor’s degree or equivalent preferred.
- Experience with Homeowners and Catastrophe (CAT) claims, particularly wind and fire events, preferred — with emphasis on understanding end-to-end claims workflows, dependencies, and process challenges.
- Proven experience in process management or business process improvement
- Advanced knowledge and practical application of process improvement tools and methodologies such as Lean, Six Sigma, or Business Process Management (BPM)
- Experience with the Duck Creek Claims platform (or similar claims management systems) preferred.
- Proficient in Microsoft Office Suite
- Exceptional attention to detail and accuracy
- Excellent communication and collaboration skills, with the ability to engage effectively with internal stakeholders, consultants, and leadership.
Top Skills
What We Do
The California FAIR Plan is a private association comprised of all insurers authorized to write property insurance in California. The FAIR Plan was established in July 1968 following the 1960s brush fires and riots as the state’s insurer of last resort, created to ensure access to basic property insurance for California homeowners who have been unable to obtain homeowners insurance from the voluntary market for reasons outside of their control. The FAIR Plan will write fire insurance coverage for these homeowners, regardless of a property’s wildfire risk.
The FAIR Plan is committed to strengthening consumer choices in the voluntary insurance market, while ensuring that all homeowners, including those who live in areas threatened by wildfires, can obtain basic property coverage and the peace of mind they deserve









