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CCMSI

TPA for workers' comp and self-insurance

AI & Process Improvement Analyst

Business OperationsConfirmed live in the last 24 hours
Full-timeRemote in USA$120k - $165k /yr

About the Job

Requirements

  • A bachelor's degree in business analytics, data analytics, information systems, computer science, business administration, insurance, or a related field is required; equivalent experience may be considered.
  • At least 4 years of experience in analytics, business process improvement, technology, insurance operations, or a related field is required.
  • Demonstrated experience using generative artificial intelligence tools and/or automation technologies is required.
  • Understanding of artificial intelligence capabilities and insurance or third-party administrator operations, including claims administration, workflows, regulatory considerations, data privacy, and human oversight in claims decisions is required.
  • Experience with Power BI, SQL, Excel, Power Automate, or similar analytical or automation tools is required.
  • Experience developing artificial intelligence prompts, workflows, or artificial-intelligence-assisted applications is required.
  • Proficiency in Microsoft Office products is required.

Responsibilities

  • Identify business processes and workflows where artificial intelligence, automation, and advanced analytics can provide measurable value.
  • Partner with claims, operations, finance, human resources, client service, information technology, and leadership teams to understand business needs and identify artificial intelligence opportunities.
  • Evaluate emerging artificial intelligence technologies for applicability to third-party administrator operations.
  • Develop business cases and recommendations for artificial intelligence initiatives, including expected benefits, costs, risks, and implementation requirements.
  • Maintain an inventory of artificial intelligence opportunities and prioritize them across the company.
  • Analyze claims and operational data to identify trends, patterns, inefficiencies, and opportunities for improvement.
  • Develop artificial-intelligence-assisted solutions for claim file summarization, document classification and extraction, correspondence drafting, medical or claims documentation review, diary and workflow prioritization, missing-information identification, quality assurance reviews, claims trend identification, and workload and productivity analysis.
  • Develop dashboards, reports, and other analytical tools that provide actionable information to management.
  • Identify opportunities to improve claims cycle time, quality, accuracy, consistency, and client-focused services.
  • Participate in the design, testing, implementation, and monitoring of artificial intelligence solutions.
  • Develop and refine prompts, workflows, and artificial intelligence use cases.
  • Test artificial-intelligence-generated outputs for accuracy, consistency, reliability, and usefulness.
  • Establish appropriate human-review processes for artificial-intelligence-assisted activities.
  • Monitor implemented artificial intelligence solutions and recommend enhancements based on performance and user feedback.
  • Document artificial intelligence processes, workflows, controls, and operating procedures.
  • Support responsible and secure use of artificial intelligence involving confidential employee, client, claimant, medical, financial, and other sensitive information.
  • Partner with information technology, information security, legal, compliance, and other stakeholders to establish appropriate artificial intelligence controls.
  • Help ensure artificial intelligence applications comply with company policies, contractual obligations, regulatory requirements, and applicable privacy standards.
  • Identify risks associated with artificial intelligence outputs, including inaccurate information, bias, inappropriate recommendations, and data-security concerns.
  • Maintain documentation of artificial intelligence models, tools, use cases, testing, controls, and approved applications.
  • Facilitate workshops, demonstrations, and adoption initiatives to encourage effective use of approved artificial intelligence solutions.
  • Develop training materials, guidelines, job aids, and best practices.
  • Serve as an internal resource for employees incorporating artificial intelligence into their work.
  • Partner with managers to identify opportunities for employees to eliminate repetitive administrative work and focus on higher-value activities.
  • Promote responsible adoption of artificial intelligence while emphasizing appropriate human judgment and accountability.
  • Apply process-improvement methodologies to evaluate workflows and determine where artificial intelligence or automation can eliminate unnecessary steps, reduce duplication, or improve quality.
  • Establish measurable performance indicators for artificial intelligence initiatives.
  • Track and report productivity improvements, time savings, quality improvements, cost savings, and employee and client impact.
  • Participate in company-wide process-improvement initiatives and other strategic projects.

Desired Qualifications

  • Experience in workers' compensation, liability, property and casualty, disability, or other insurance-related operations.
  • Experience working for or with a third-party administrator.
  • Experience with claims systems and insurance data.
  • Knowledge of data governance, privacy, information security, and artificial intelligence risk management.
  • Experience with process-improvement methodologies such as Lean, Six Sigma, or Kaizen.
  • Lean Six Sigma Green Belt or Black Belt certification.
  • Microsoft Copilot certification.
  • Microsoft Power Platform certification.
  • Artificial-intelligence-related professional certification.

About the Company

CCMSI

TPA for workers' comp and self-insurance

CCMSI provides third-party administration services for workers' compensation and property/casualty self-insurance programs. It manages claims and offers risk management and cost-containment strategies for self-insured entities, including group self-insurance associations. The product works by acting as an administrator for a client’s self-insurance program: handling claims, administering payments, and implementing risk controls and cost-saving measures on a fee basis. CCMSI differentiates itself by focusing on the self-insurance niche and serving organizations that bear their own insurance risks, rather than selling traditional insurance policies. The company’s goal is to help clients reduce claim costs and manage their self-insurance programs more effectively.

Company size
1,001-5,000
Company stage
Not listed
Total funding
Not listed
Headquarters
Danville, IL
Founded
1978

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