Claims Process Analyst

Peyton Resource Group

San Antonio, TX

JOB DETAILS
LOCATION
San Antonio, TX
POSTED
21 days ago

Our client is seeking a detail-oriented Claims Process Analyst to join their Claims Payments team, supporting Property & Casualty (P&C) claims operations. This role focuses on risk identification, compliance, and process integrity to ensure claims payments are accurate, timely, and aligned with operational standards.

You will play a critical role in analyzing claims that require deeper investigation, identifying root causes of payment issues, and recommending process improvements to prevent future errors.

Key Responsibilities
  • Analyze large volumes of claims data (e.G., 500–800+ claims at a time) to validate system accuracy and process effectiveness
  • Conduct root cause analysis to identify whether issues stem from system defects, process gaps, or compliance risks
  • Prioritize and manage backlog reports, focusing on high-impact claims and time-sensitive issues
  • Partner with adjusters, claims operations, and underwriting teams to resolve payment exceptions and discrepancies
  • Identify opportunities to streamline workflows, improve controls, and enhance overall process efficiency
  • Develop and refine standard operating procedures (SOPs) where gaps or inconsistencies exist
  • Complete required documentation, including forms, reports, and member/customer communications (letters)
  • Respond to ad hoc analysis requests and provide clear, actionable insights
  • Deliver summaries and recommendations to leadership, supporting continuous improvement initiatives

Required Qualifications
  • Experience in Property & Casualty (P&C) claims or claims operations
  • Background in claims payments, underwriting support, or financial operations within insurance
  • Familiarity with claims systems such as Guidewire or similar platforms
  • Strong analytical and problem-solving skills with high attention to detail
  • Ability to assess and differentiate system, process, and compliance-related issues
  • Experience working in fast-paced, unstructured environments with shifting priorities
  • Strong written communication skills, including the ability to summarize findings and provide recommendations

About the Company

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Peyton Resource Group

Established in 2001, Peyton Resource Group is a solution-based staffing company that matches businesses with top talent for short-term, long-term or permanent needs. People are a business’s most valuable asset. Peyton Resource Group is dedicated to helping companies find the best talent, matching professionals with jobs where they will thrive. With locations in Dallas/Fort Worth, San Antonio and Austin, we are available to serve your staffing needs throughout Texas and across the country.
COMPANY SIZE
100 to 499 employees
INDUSTRY
Staffing/Employment Agencies
WEBSITE
https://www.prg-usa.com/