Insurance Process Expert

We are seeking an experienced Insurance Process Expert to analyze, evaluate and challenge documented process flows across underwriting, issuance, claims and customer service. In this role, you will identify gaps between the current state and the target state and determine where artificial intelligence can be implemented without compromising business rules or industry regulatory requirements within the Colombian insurance sector.

Responsibilities

• Interview leaders and operators of the three prioritized processes
• Review and critically evaluate the To-Be flows in BPMN 2.0 documented by the client
• Identify gaps between the documented To-Be and the current operational reality
• Detect real pain points of traceability and prolonged times by process and line of business
• Map the critical business rules that must be respected in any AI implementation
• Identify AI use cases with the greatest operational impact by process
• Evaluate which decisions can be autonomous with AI and which require human validation under SFC regulation
• Build the framework for prioritizing quick wins for each process to be redesigned

Requirements

• At least 8 years of experience, including at least 5 years directly in the insurance industry
• In-depth knowledge of underwriting and issuance processes covering risk assessment, business rules and delegation
• Mastery of claims processes including claims notification, analysis, classification, decision and settlement
• Knowledge of insurance distribution channels in Colombia such as intermediaries, portals and omnichannel
• Proficiency in BPMN 2.0 for reading, analyzing and critically evaluating process flows
• Understanding of the SFC regulatory framework applicable to automated decisions in insurance
• Functional knowledge of core insurance systems, both in-house and commercial platforms
• Skills in process analysis methodologies including value stream mapping and bottleneck identification
• Functional understanding of AI applied to insurance covering scoring models, OCR in documents and assisted decision-making
• Understanding of the Colombian regulatory framework applicable to the insurance sector with experience in multiple lines of business including life, general, auto and health
• Insurance training: FASECOLDA, ACOLDESE or university degree in related fields

Nice to have

• Process analysis certification: Lean Six Sigma Green Belt or higher
• Training in AI applied to insurance or fintech