Business Systems Analyst - Healthcare Plan - REMOTE

Day to Day Responsibilities Include:

• Work with business users to define and analyze problems and align the most appropriate technical, application or configuration solutions.
• Provide oversight of business requirement/specification maintenance via workflow system in accordance with customer deliverables.
• Solicit, develop, document and manage requirements and provide detailed design to support the requirements throughout project life cycle
• Review system test plans and system tests modules before implementation.
• Work with the user to select or create appropriate scenarios to test all results to determine whether system changes met project specifications; use scenarios to assist the end user in acceptance testing.
• Conduct business process analyses, needs assessments, and preliminary cost/benefits analyses in an effort to align information technology solutions with business initiatives.
• Interprets business system configuration requests, and assigns to configuration staff in accordance with provider/employer contracts, and customer needs.
• Interacts with client to determine innovative technical solutions to workflow implementation issues.
• Provides consultative services by actively participating on numerous cross-functional teams and projects, as well as troubleshooting inquiries and issues from multiple business owners.
• Resolves software and data issues and investigates accuracy of user transactions and their effects on the workflow system.
• Researches complex problems to ascertain possible solutions.
• Design and implement solutions to support key business objectives, including developing design requirements and technical specifications.
• Develops, maintains, and disseminates internal and external system documentation, including status updates; prepares procedural and customer documentation when required.
• Provides technical guidance and influences the work of others involved in system configuration solutions.
• Consider the business implications of the application of technology to the current and future business environment.
• Communicate with Client, Client Executives, and all members of the delivery team.
• Main point of contact for Support - receive, log, and track defects and change requests

• 3 + years Healthcare industry experience, with business knowledge of benefits, claim systems, and adjudication principles.
• 5+ years of advanced knowledge of system development methodology, project management, system architecture and business analytical/problem solving skills.

• Experience with medical claim business system software.
• Solid knowledge of medical and/or benefit policies, provider contract and/or employer plan designs, professional and facility claim processing, and medical terminology and industry standard code sets
• Knowledge of enrollment or claims EDI transactions and file formats (834, 837, 835) familiarity and experience with data mapping desired.
• Agile experience a plus.
• Must be able to manage multiple assignments, independently determine solutions, and anticipate/prevent potential problems.
• Strong analytical, organizational, interpersonal and communication skills.