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Claims TPA Business Analyst
Claims TPA Business AnalystSompo International • Irvine, CA, US
Claims TPA Business Analyst

Claims TPA Business Analyst

Sompo International • Irvine, CA, US
19 hours ago
Job type
  • Full-time
Job description

Claims Tpa Business Analyst

Sompo has a unique opportunity for a Claims Tpa Business Analyst in our Claim Operations team.

This role will serve as a critical liaison between business stakeholders, Third Party Administrators (TPAs), and technical teams to optimize claims data, ensure data integrity, and support efficient delegated authority workflows. The ideal candidate will have a deep understanding of commercial Property & Casualty (P&C) and Specialty insurance claims processes.

Location : This position may be based out of one of our offices in Irvine, CA; Charlotte, NC; Alpharetta, GA; New York, NY; or Purchase, NY. We strive for collaboration which is why we offer a work environment where our employees thrive and develop long lasting careers.

Our business, your impact, our opportunity :

What you'll be doing :

  • Analyze, document, and improve claims data flows related to Third Party Administration and Delegated Authority arrangements. Ensure accurate and timely transmission of data.
  • Gather, interpret, and validate complex data feeds from multiple sources, ensuring accuracy and consistency for reporting and analytics.
  • Define and translate business requirements into functional specifications for IT and external vendors.
  • Support the design and implementation of automated claims workflows and data integration solutions.
  • Monitor key performance indicators (KPIs) and produce regular management reports to track claims performance and compliance.
  • Facilitate UAT (User Acceptance Testing) for new claims systems or process enhancements.
  • Identify operational risks and propose mitigations related to delegated authority claims handling.

What you'll bring :

  • Proven experience as a Business Analyst within commercial P&C and Specialty insurance claims environments.
  • In-depth knowledge of Third Party Administration models and Delegated Authority arrangements in insurance.
  • Experience managing and interpreting complex claims data feeds, including data mapping, validation, and integration.
  • Strong analytical skills with the ability to translate complex business needs into clear technical requirements.
  • Familiarity with claims management systems and data platforms used by insurers and TPAs.
  • Excellent communication and stakeholder management skills, with the ability to work collaboratively across multiple teams.
  • Strong problem-solving skills and attention to detail.
  • Experience with Agile methodologies and tools is a plus.
  • Relevant certifications (e.g., CBAP, PMI-PBA) or insurance industry qualifications are desirable.

    • Salary Range : $75,000 $135,000 Actual compensation for this role will depend on several factors including the cost of living associated with your work location, your qualifications, skills, competencies, and relevant experience.

    At Sompo, we recognize that the talent, skills, and commitment of our employees drive our success. This is why we offer competitive, high-quality compensation and benefit programs to eligible employees.

    Our compensation program is built on a foundation that promotes a pay-for-performance culture, resulting in higher incentive awards, on average, when the Company does well and lower incentive awards when the Company underperforms. The total compensation opportunity for all regular, full-time employees is a combination of base salary and incentives that gets adjusted upfront based on overall Company performance with final awards based on individual performance.

    We continuously evaluate and update our benefit programs to ensure that our plans remain competitive and meet the needs of our employees and their dependents. Below is a summary of our current comprehensive U.S. benefit programs :

  • Two medical plans to choose from, including a Traditional PPO & a Consumer Driven Health Plan with a Health Savings account providing a competitive employer contribution
  • Pharmacy benefits with mail order options
  • Dental benefits including orthodontia benefits for adults and children
  • Vision benefits
  • Health Care & Dependent Care Flexible Spending Accounts
  • Company-paid Life & AD&D benefits, including the option to purchase Supplemental life coverage for employee, spouse & children
  • Company-paid Disability benefits with very competitive salary continuation payments
  • 401(k) Retirement Savings Plan with competitive employer contributions
  • Competitive paid-time-off programs, including company-paid holidays
  • Competitive Parental Leave Benefits & Adoption Assistance program
  • Employee Assistance Program
  • Tax-Free Commuter Benefit
  • Tuition Reimbursement & Professional Qualification benefits

    • Ethics and integrity are the foundation of delivering on our commitment to you. We believe that core values drive success, and that when relationships are held in the highest regard, there is nothing that cannot be accomplished. At Sompo, our ring is more than a logo, it is a symbol of our promise. Click here to learn more about life at Sompo.

    Sompo is an equal opportunity employer and we intentionally value inclusion and diversity. Above all, we want you to work in an environment that respects everyone's unique contributions we are passionately committed to equal opportunities. We do not discriminate based on race, color, religion, sex orientation, national origin, or age.

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