Senior Claims Application Analyst at Pie Insurance

, , United States -

Full Time

Start Date

Immediate

Expiry Date

11 May, 26

Salary

160000.0

Posted On

10 Feb, 26

Experience

10 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Claims Operations, Requirements Gathering, Documentation, Stakeholder Collaboration, System Design, Integration Management, User Acceptance Testing, Training, Change Management, Continuous Improvement, Project Management, Communication, Problem Solving, Agile Methodologies, Technical Requirements, Business Analysis

Industry

Insurance

Description

Pie's mission is to empower small businesses to thrive by making commercial insurance affordable and as easy as pie. We leverage technology to transform how small businesses buy and experience commercial insurance. Like our small business customers, we are a diverse team of builders, dreamers, and entrepreneurs who are driven by core values and operating principles that guide every decision we make. The Senior Claims Application Analyst serves as the critical bridge between Claims business operations and technology solutions, identifying and translating organizational needs into technology-based solutions that improve efficiency, reporting, compliance, and scalability. This role is responsible for identifying, gathering, and documenting system requirements for Pie's core claims platform, its various API integrations (medical bill review, legal bill review, payment processing, fraud software, etc.), and enterprise systems such as digital mailroom solutions. The analyst will design and lead Claims UAT efforts, support application creation and integrations, deliver end-user training, and partner with Enterprise Tech and external vendors to drive continuous improvements that enhance user and customer experience. How You'll Do It Requirements Gathering & Documentation: Identify, gather, and document detailed system requirements for the core claims platform and Claims technology ecosystem Translate complex business needs from Claims stakeholders into clear, actionable technical requirements Collaborate with Claims business units to understand pain points, workflow inefficiencies, and enhancement opportunities Document current state processes and design future state solutions that leverage technology capabilities Create comprehensive business requirements documents (BRDs), functional specifications, and process flows Maintain requirements traceability throughout the development and implementation lifecycle Stakeholder Collaboration & Communication: Serve as primary liaison between Claims business units, Enterprise Tech team, and Product team Communicate Claims requirements and priorities to external vendor partners and integration vendors Facilitate requirements gathering sessions with Claims Adjudication, Operations, Regulatory Compliance, and other teams Present system enhancement proposals to Claims leadership with business case justifications Partner with Enterprise Tech to ensure technical feasibility and alignment with enterprise architecture Independently manage stakeholder expectations throughout project lifecycles System Design & Integration Management: Collaborate with Product team and Product Manager on backlog grooming, story refinement, and sprint planning activities; assist with sizing and estimating user stories and tasks Support application creation, configuration, and customization within core claims platform Design and document API integrations between the core claims platform and third-party solutions (medical bill review, legal bill review, payment processing, fraud detection, etc.) Work with vendors to ensure seamless integration of enterprise systems such as digital mailroom solutions Design process workflows that optimize system capabilities and user experience Identify opportunities to leverage automation and technology to reduce manual processes Ensure system designs support reporting, compliance, and scalability requirements User Acceptance Testing (UAT) Leadership: Design and lead comprehensive Claims UAT efforts for system enhancements and new feature deployments Develop UAT plans, test scripts, and acceptance criteria aligned with business requirements Recruit and coordinate UAT participants from across Claims business units Lead UAT sessions, document findings, and track defect resolution Ensure successful deployment and adoption of new features through rigorous testing protocols Validate that delivered solutions meet business requirements and quality standards Training & Change Management: Deliver end-user training programs for new system features and enhancements Create training materials including user guides, quick reference documents, and video tutorials Conduct training sessions for Claims teams on system functionality and process changes Support change management efforts to drive user adoption of new technologies Provide ongoing support to end users for system issues and questions Gather user feedback post-implementation to identify additional training needs Continuous Improvement & Innovation: Work with Claims business units to drive continuous improvements in systems and processes Monitor system performance and user feedback to identify enhancement opportunities Stay current with core claims platform updates and new capabilities Research and recommend new technologies and integrations to enhance Claims operations Participate in industry forums and user groups to learn best practices and innovative solutions Apply agile methodologies to iteratively improve systems based on evolving business needs Subject Matter Expertise & Project Support: Serve as Claims applications subject matter expert (SME) for system enhancement and integration projects Provide expert guidance on Claims business processes, system functionality, and technical requirements throughout project lifecycles Participate in prioritization ceremonies and provide input on business value, technical dependencies, and Claims impact Support project teams with Claims domain knowledge to ensure solutions meet business needs Identify and communicate project risks and issues from a Claims business perspective Validate that project deliverables align with Claims requirements and quality standards Coordinate Claims stakeholder involvement in projects including resource planning and availability The Right Stuff Required Experience & Education: Bachelor's degree in Business Administration, Information Systems, Computer Science, or related field 8+ years of experience in business systems analysis, preferably in insurance or claims environment 5+ years of experience with software development lifecycle, UAT, and agile project management methodologies 5+ years of experience with workers' compensation claims operations with strong understanding of the claims lifecycle Experience with insurance claims management systems; Origami Risk experience is a plus Proven track record of successfully translating business requirements into technical solutions Technical & System Knowledge: Strong knowledge of workers' compensation claims lifecycle, processes, and regulatory requirements Experience with insurance claims management systems and platforms Understanding of API integrations and system architecture concepts Familiarity with data flow, system interfaces, and integration patterns Knowledge of digital mailroom solutions and document management systems Experience with medical bill review, legal bill review, and fraud detection software integrations Proficiency with requirements documentation tools, process mapping software, and project management platforms Business Analysis & Project Management: Advanced skills in requirements gathering, analysis, and documentation Strong process design capabilities with ability to identify optimization opportunities Expertise in UAT planning, execution, and defect management Experience with agile methodologies including sprint planning, user stories, and iterative development Ability to serve as subject matter expert on cross-functional project teams Ability to create business cases with ROI analysis and cost-benefit justification Communication & Stakeholder Management: Exceptional communication skills with ability to translate technical concepts to business audiences and vice versa Experience presenting to senior leadership and building consensus across diverse stakeholder groups Strong facilitation skills for requirements sessions, UAT, and training delivery Ability to manage competing priorities and negotiate scope with stakeholders Experience managing vendor relationships and holding partners accountable for deliverables Excellent written communication skills for creating clear, comprehensive documentation Expert Level Competencies: Recognized internally as subject matter expert in Claims systems and business analysis Leads and contributes to development of company objectives and principles related to Claims technology strategy Translates functional plans into operational processes and guides execution Works on significant and unique system challenges requiring evaluation of complex technical and business factors Exercises independent judgment in methods, techniques, and evaluation criteria for system solutions Consistently demonstrates curiosity, tenacity, flexibility, and adaptability in addressing complex challenges Seeks to understand multiple points of view and presents complex information in a direct and open manner Creates win/win forward-looking solutions that demonstrate innovation and creativity Evaluates and prioritizes the needs of multiple stakeholders, putting those needs first Achieves cross-functional goals and builds buy-in for complex proposals and projects Personal Attributes: Analytical mindset with strong problem-solving and critical thinking abilities Detail-oriented with commitment to accuracy in requirements and documentation Self-motivated with ability to work independently on assigned projects Adaptable to changing priorities and comfortable with ambiguity Customer-focused with commitment to improving user experience Continuous learner who stays current with technology trends and best practices Collaborative approach with ability to build trust across business and technical teams The use of AI in Application Review: To support a fair, efficient, and consistent hiring process, we use AI-powered tools to assist in the initial screening of applications. These tools help us identify qualifications and prior work experiences that align with the requirements of the role. We may also use AI assistant video tools during interviews to support note-taking and candidate evaluation. All AI-powered outputs are still subject to human oversight and decision-making at multiple stages of the process. By submitting your application, you acknowledge and consent to Pie utilizing these AI technologies to assist in our evaluation process. Base Compensation Range $130,000—$160,000 USD Compensation & Benefits Competitive cash compensation A piece of the pie (in the form of equity) Comprehensive health plans Generous PTO Future focused 401k match Generous parental and caregiver leave Our core values are more than just a poster on the wall; they’re tangibly reflected in our work Our goal is to make all aspects of working with us as easy as pie. That includes our offer process. When we’ve identified a talented individual who we’d like to be a Pie-oneer , we work hard to present an equitable and fair offer. We look at the candidate’s knowledge, skills, and experience, along with their compensation expectations and align that with our company equity processes to determine our offer ranges. Each year Pie reviews company performance and may grant discretionary bonuses to eligible team members. Location Information Unless otherwise specified, this role is remote. Remote team members must live and work in the United States (territories excluded) and have access to reliable, high-speed internet. Additional Information Pie Insurance is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military service status, citizenship, or other protected characteristic. Pie Insurance participates in the E-Verify program. Please click here, here and here for more information. Pie Insurance is committed to protecting your personal data. Please review our Privacy Policy. Safety First: Pie Insurance is committed to your security during the recruitment process. We will never ask you for credit card information or ask you to purchase any equipment during our interview or onboarding process. Pie Named to 2025 America's Best Startup Employers Pie Insurance 2025 State of Workplace Safety Report #LI-REMOTE #BI-REMOTE

Responsibilities

The Senior Claims Application Analyst serves as a bridge between Claims business operations and technology solutions, translating organizational needs into technology-based solutions. This role involves gathering system requirements, leading UAT efforts, and partnering with teams to enhance user and customer experience.