Senior Business Analyst - Medical Claims Processing

Remote, USA Full-time
Description We’re seeking experienced and highly motivated Senior Business Analysts with a strong background in medical claims to join our expanding team. This is a fantastic opportunity to leverage your expertise in a fully remote, 12-month contract role, with potential for conversion to full-time employment. If you thrive in a fast-paced, client-facing environment and possess a deep understanding of claims processing and adjudication, we want to hear from you! Company Culture and Environment Our work environment is collaborative and supportive, fostering teamwork and communication. We value customer focus and encourage our team members to engage fully in their roles. Career Growth and Development Opportunities This role provides an opportunity to grow your career within a rapidly growing industry and potentially transition into a full-time position. Detailed Benefits and Perks • 100% remote work flexibility • Opportunity to work in a rapidly growing industry • Potential for conversion to full-time employment • A collaborative and supportive work environment • Opportunity to grow your career Compensation and Benefits This is a W2 contract position with a competitive compensation package. Candidates must be US Citizens or GC-EAD holders. A drug test is required. Why you should apply for this position today This position offers the chance to leverage your skills in a crucial role that bridges clients and development teams, making a significant impact on claims management systems. Skills • 5-7+ years of experience as a Business Analyst and Systems Analyst • Extensive experience with medical claims processing and adjudication, including EDI 837 • Proven experience in software implementation projects • Strong client-facing skills • Experience in requirements gathering • Ability to create test plans, test cases, and test scenarios • Excellent analytical and problem-solving skills • Strong communication and presentation skills • Ability to perform logic testing • Proficiency in Microsoft Office Suite (Word, PowerPoint, Excel, Visio) Responsibilities • Collaborate with clients to understand their needs and gather detailed requirements • Serve as a trusted advisor to clients regarding claims management systems • Support the implementation of solutions, including configuring claims systems • Develop and execute comprehensive test plans and scenarios • Troubleshoot issues and identify root causes • Document granular requirements for ClaimsXten rules development • Utilize tools like Excel for data analysis Qualifications • Strong analytical and problem-solving skills • Ability to articulate ClaimsXten rules development • SQL query writing experience (nice to have) • Experience with data mapping, modeling, profiling, and warehousing (nice to have) • Medical coding or billing experience (CPC certification, nice to have) • Financial background (nice to have) Education Requirements • Bachelor’s degree in a related field preferred Education Requirements Credential Category • Relevant certifications in Business Analysis or related fields are a plus Experience Requirements • 5-7+ years of relevant experience in business and systems analysis Why work in Philipsburg, PA Philipsburg offers a serene environment with a close-knit community feel. Enjoy the tranquility of small-town living while having access to larger cities for additional amenities and entertainment options, providing a balanced lifestyle that supports both personal and professional growth. Apply tot his job
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