AI-Driven Claims Operations Analyst

Fortegra; Jacksonville (FL); On-site; USD 70,000 - 100,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Life insurance

Vision benefits

Disability (short/long-term)

401(k)

Tuition assistance

Job summary

Fortegra is seeking a Claims Operations Analyst in Jacksonville to drive data-driven decision support across claims activities. You will build and maintain monthly and ad hoc reports, analyze claims and billing data, and apply AI-enabled analytics to improve accuracy and efficiency.

You will partner with cross-functional leaders to define metrics, translate data into executive summaries, and support continuous improvement of reporting processes within a fast-paced environment.

Qualifications

• Education: High School Diploma or equivalent work experience.
• Experience: At least 2-3 years of experience in related field.

Responsibilities

• Develop, enhance, and maintain recurring, monthly, and ad hoc claims operations reporting to support business visibility and performance management.
• Analyze claims, billing, and operational data to identify trends, patterns, and actionable insights for leadership decision-making.
• Leverage AI-enabled tools and reporting capabilities to improve data accuracy, reporting efficiency, and analytical depth.
• Translate complex data sets into clear, executive-ready summaries, dashboards, and performance narratives.
• Support billing oversight activities including reconciliation, discrepancy identification, and resolution tracking.
• Assist with claims-related operational processes such as payments, reimbursements, and vendor incident reporting.
• Ensure data integrity across claims operations systems, reporting platforms, and operational datasets.
• Partner cross-functionally with leadership and operational teams to define reporting needs and performance metrics.
• Monitor operational performance indicators and proactively surface insights that support strategic and tactical decisions.
• Support servicer and vendor compliance tracking, including Certificates of Insurance and required documentation management.
• Contribute to continuous improvement initiatives by identifying opportunities to automate, streamline, or enhance reporting processes.
• Support data validation, system updates, and reporting governance standards to ensure consistency and reliability.

Skills

Analytical mindset

Excel proficiency

Data visualization

Reporting tools

AI-enabled analytics

Education

High School Diploma or equivalent

Tools

Excel

Power BI

Tableau

Job description

Fortegra is seeking a Claims Operations Analyst in Jacksonville to drive data-driven decision support across claims activities. You will build and maintain monthly and ad hoc reports, analyze claims and billing data, and apply AI-enabled analytics to improve accuracy and efficiency.

You will partner with cross-functional leaders to define metrics, translate data into executive summaries, and support continuous improvement of reporting processes within a fast-paced environment.