Business Systems Analyst With Healthcare Claims

Job Description:

Business Analysis & Solution Design

• Elicit, analyze, and document complex business, operational, and system requirements
• Translate business problems into functional requirements, workflows, process models, and user stories

AI  & Intelligent Automation Enablement

• Translate business risks and operational challenges into AI-ready business requirements
• Define business rules, signals, thresholds, and intervention logic supporting AI-enabled workflows

Preferred Experience

• 10+ years of Business Analysis / Business Systems Analysis experience
• Strong U.S. Healthcare experience working with all Lines of businesses
• Payment Integrity, Claims, FWA/Revenue Cycle Management experience
• Experience supporting AI, advanced analytics, or intelligent automation initiatives
• Healthcare claims processing and adjudication knowledge
• Knowledge of lifecycle of a claim is a “MUST”. Claims processing is an added advantage
• SQL and data analysis capabilities
• Experience working with Databricks, Snowflake, Tableau, or Power BI preferred