We are looking for a Task & Process Mining Analyst with 5+ years of experience in business/process analysis and strong experience in healthcare claims operations. The ideal candidate will have hands-on experience with process mining and task mining tools and will use data-driven insights to identify process inefficiencies, quantify automation opportunities, and support RPA and AI-led transformation initiatives.
Key Responsibilities:
Process & Task Mining:
- Deploy and configure process mining solutions to analyze event-log data from healthcare claims systems and reconstruct end-to-end process flows.
- Use Task Mining to capture and analyze desktop-level user interactions across claims intake, validation, adjudication, remittance, and denial workflows.
- Identify process variants, bottlenecks, rework loops, manual touchpoints, and compliance deviations.
- Build and maintain process mining dashboards and conformance models to monitor process performance.
- Create objective, data-driven as-is process documentation based on actual process execution.
Healthcare Claims Analysis:
- Analyze end-to-end healthcare claims workflows including EDI 837/835, eligibility verification, prior authorization, claims submission, adjudication, remittance, denial management, and appeals.
- Analyze payer-provider interaction points and identify root causes of denials, delays, rework, and manual intervention.
- Quantify transaction volumes, cycle times, error rates, rework, and manual effort to support ROI and business-case development.
- Collaborate with claims SMEs, clinical teams, billing teams, and operations stakeholders to validate findings and prioritize improvement opportunities.
Automation Opportunity Development:
- Translate process and task mining findings into structured automation opportunities.
- Define automation scope, effort estimates, expected benefits, and ROI projections.
- Develop Process Definition Documents (PDDs) and solution-design inputs for RPA development teams.
- Prioritize automation opportunities based on volume, complexity, compliance risk, and business value.
- Partner with UiPath RPA developers and architects to support the transition from process discovery through automation development.
Stakeholder Engagement:
- Present process mining findings, dashboards, insights, and automation business cases to healthcare operations and IT stakeholders.
- Facilitate workshops with claims SMEs, billing teams, payer relations teams, and other stakeholders.
- Validate current-state processes and support future-state process design.
- Support change management and process transformation activities during automation implementation.
Required Qualifications:
- 5+ years of experience in business/process analysis, with at least 2 years of experience focused on healthcare claims operations.
- Hands-on experience with UiPath Process Mining and/or Task Mining or equivalent tools such as Celonis, Minit, or Fluxicon Disco.
- Strong understanding of the healthcare claims lifecycle, including EDI 837/835, eligibility, prior authorization, adjudication, denials, remittance, and appeals.
- Experience working with healthcare claims platforms such as Epic (Resolute HB/PB), Facets, TriZetto, Availity, or Change Healthcare.
- Experience with process mapping and process documentation tools such as Visio or Lucidchart.
- Strong analytical skills with the ability to analyze event-log/process data and develop ROI models and business cases.
- Familiarity with HIPAA compliance and PHI handling requirements.
- Experience with RPA platforms, preferably UiPath, and understanding of the automation development lifecycle.
- Strong communication, stakeholder management, and problem-solving skills.
Preferred Qualifications:
- UiPath Process Mining or Task Mining certification.
- Lean, Six Sigma, or other process improvement experience/certification.
- Experience with SQL for event-log extraction and data preparation.
- Knowledge of HL7, FHIR, and healthcare interoperability standards.
- Exposure to AI/ML-enhanced process mining use cases such as anomaly detection or predictive conformance.
- PMP or Agile certification.
Success in this role will involve establishing process mining models for key claims workflows, identifying and prioritizing high-value automation opportunities with validated ROI, reducing claims denials, rework, manual processing time, and enabling healthcare stakeholders to use process performance dashboards for ongoing decision-making.
