Healthcare / Financial Business Analyst

Introduction

We are seeking an experienced Senior Healthcare / Financial Business Analyst to analyze complex business processes, financial operations, healthcare workflows, and technology solutions. The ideal candidate will work closely with business stakeholders, IT teams, finance teams, healthcare operations, and leadership to translate business needs into clear functional requirements and deliver effective technology solutions.

Responsibilities

• Analyze healthcare and financial business processes, workflows, and operational requirements.
• Gather, document, and validate business and functional requirements from stakeholders.
• Conduct requirements elicitation through interviews, workshops, process reviews, and data analysis.
• Translate business requirements into detailed BRDs, FRDs, user stories, use cases, process flows, and acceptance criteria.
• Analyze healthcare claims, billing, eligibility, enrollment, payments, revenue cycle, financial transactions, and related processes.
• Work with finance teams on budgeting, forecasting, reconciliation, reporting, and financial analysis requirements.
• Identify process gaps, inefficiencies, risks, and opportunities for automation or improvement.
• Partner with developers, architects, QA teams, product owners, and project managers throughout the software development lifecycle.
• Perform data analysis and validation using SQL, Excel, reporting tools, and other analytical technologies.
• Develop and maintain process maps, data flows, business rules, and functional specifications.
• Support system integrations and data exchange between healthcare, financial, and enterprise applications.
• Participate in system testing, integration testing, UAT, defect analysis, and production validation.
• Create test scenarios and validate that delivered solutions meet business requirements.
• Investigate production issues and coordinate with technical teams to identify root causes and resolutions.
• Support regulatory, compliance, audit, and reporting requirements within healthcare and financial environments.
• Prepare dashboards, reports, presentations, and executive-level business analysis deliverables.
• Facilitate meetings and communicate effectively with both technical and non-technical stakeholders.
• Mentor junior business analysts and contribute to business analysis standards and best practices.

Requirements

Required Qualifications

• Bachelor's degree in Business Administration, Finance, Healthcare Administration, Information Technology, or a related field.
• 10+ years of experience in business analysis, with significant experience in healthcare, financial services, insurance, or related industries.
• Strong understanding of healthcare business processes and/or financial operations.
• Experience with requirements gathering, process modeling, gap analysis, and solution design.
• Strong analytical, problem-solving, and critical-thinking skills.
• Experience working in Agile, Scrum, Waterfall, or hybrid SDLC environments.
• Strong knowledge of SQL and data analysis techniques.
• Advanced proficiency with Microsoft Excel, PowerPoint, and Visio or equivalent process-modeling tools.
• Experience developing BRDs, FRDs, user stories, use cases, process flows, and test documentation.
• Excellent communication, presentation, facilitation, and stakeholder-management skills.

Preferred Qualifications

• Experience with healthcare payers, providers, claims, enrollment, eligibility, billing, or revenue cycle management.
• Knowledge of Medicare, Medicaid, commercial insurance, healthcare claims, EDI, HIPAA, and healthcare data standards.
• Experience with financial systems, general ledger, accounts payable/receivable, reconciliation, budgeting, forecasting, or revenue management.
• Familiarity with 837, 835, 270/271, 834, and 276/277 EDI transactions.
• Experience with healthcare or financial applications such as Epic, Facets, QNXT, HealthRules, SAP, Oracle Financials, PeopleSoft, or similar platforms.
• Experience with Power BI, Tableau, or other business intelligence tools.
• Knowledge of APIs, web services, ETL/data integration, and enterprise application integrations.
• CBAP, PMI-PBA, or other business analysis certification is a plus.

Key Skills

Business Analysis | Healthcare | Financial Analysis | Requirements Gathering | SQL | Data Analysis | Healthcare Claims | Revenue Cycle | Financial Systems | Process Improvement | BRD/FRD | User Stories | UAT | Agile/Scrum | EDI | HIPAA | Reporting | Stakeholder Management | SDLC

Education

Bachelor's degree in Business, Finance, Healthcare Administration, Information Technology, Computer Science, or a related discipline.