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Job Title : Claims Analyst
Location : Johnston, RI 02919 (Hybrid)
Duration : 12 Months
Job Details:
Minimum years of experience required: 8 years Certification needed: None Must Have Skills: Domain SME in Claims and fraud operations Nice to Have Skills: Agentic AI exposure
Detailed Job Description:
Role Description:
We are building the next generation of our claims management platform, transforming how claims are supported through intelligent automation.
This role brings deep industry knowledge and hands-on operational expertise to shape what we build, grounded in both real-world experience and industry best practices.
Leads the translation of claims and fraud operations into intelligent and agentic automation capabilities.
Ensures our automation and agentic capabilities reflect how claims are actually worked, not just how they are designed.
Key Responsibilities:
Job Title : Claims Analyst
Location : Johnston, RI 02919 (Hybrid)
Duration : 12 Months
Job Details:
Minimum years of experience required: 8 years Certification needed: None Must Have Skills: Domain SME in Claims and fraud operations Nice to Have Skills: Agentic AI exposure
Detailed Job Description:
Role Description:
We are building the next generation of our claims management platform, transforming how claims are supported through intelligent automation.
This role brings deep industry knowledge and hands-on operational expertise to shape what we build, grounded in both real-world experience and industry best practices.
Leads the translation of claims and fraud operations into intelligent and agentic automation capabilities.
Ensures our automation and agentic capabilities reflect how claims are actually worked, not just how they are designed.
Key Responsibilities:
- Translate Operations and Best Practices into Product Capabilities: Define how claims workflows, decisions, and edge cases translate into scalable product capabilities, automation, and agentic solutions.
- Shape High-Impact Use Cases: Drive the collaboration across Fraud and Claims Operations, Evergreen (GenAI Agentic team) and Cypress platform teams to define and refine use cases spanning intake, investigation, evidence gathering, decision support, and resolution.
- Validate Target-state Workflows: Shape end-to-end workflows that enable agentic solutions, ensuring alignment with real-world execution while improving efficiency, consistency, usability, and automation outcomes.
- Drive Measurable Outcomes: Help define and track success metrics such as cycle time reduction, improved investigator productivity, and reduction in manual handling.
- Deep, hands-on expertise in claims operations, spanning intake, investigation, and resolution, with strong awareness of industry best practices.
- Collaborative leadership, with demonstrated ability to work effectively across business and technology groups.
- Excellent communications skills, with the ability to represent the voice of real-world claims operations while influencing toward more scalable and effective ways of working through new capabilities such as agentic solutions.