AI-Driven Healthcare Claims Analyst

Reveal Global Consulting, LLC; Northern (KY); Ibrido; USD 90.000 - 130.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical plan

Vision plan

Life insurance

Disability insurance (short-term)

Disability insurance (long-term)

401K retirement plan

Flexible spending

EAP

Paid time off

Descrizione del lavoro

Reveal Global Consulting, LLC is seeking a Business Analyst to bridge auditors and our AI team in healthcare claims and program integrity. You will gather requirements, document workflows, and translate needs into actionable user stories and acceptance criteria.

You will manage the backlog in Jira, run Agile sprints, support UAT, and prepare user guides while keeping stakeholders informed. A federal background investigation is required. Fulton, MD onsite position.

Competenze

• Bachelor's degree in business, healthcare administration, public health or a related field.
• 4+ years as a business analyst or in a related role.
• Experience with healthcare claims investigations or audits (e.g., SIU or program integrity).
• Hands-on experience with healthcare provider data (NPI, taxonomy, enrollment).
• SQL for querying and analyzing claims data.
• Knowledge of CPT/HCPCS, ICD-10, NDC codes and fraud schemes.
• Experience with Jira and Agile sprints.
• Experience using AI agents or tools to speed up requirements work.
• Strong facilitation, meeting-minute and documentation skills.
• Ability to pass a federal background investigation.

Mansioni

• Work with auditors and investigators to identify AI use cases.
• Gather and document business requirements, workflows and success measures.
• Use AI tools to draft and refine requirements documents, user stories and acceptance criteria.
• Take clear meeting minutes and track decisions and actions.
• Map audit processes to identify AI value.
• Manage the backlog in Jira and support sprint planning/reviews/retrospectives.
• Support UAT and evaluate AI outputs with user feedback.
• Write user guides and training materials and assist training sessions.
• Keep stakeholders updated on progress and open questions.

Conoscenze

Business analysis

SQL

Jira

Agile/Sprints

Facilitation

Requirements docs

AI tools

Meeting minutes

Stakeholder communication

Formazione

Bachelor's degree

Strumenti

Jira

Healthcare data tools

Descrizione del lavoro

Reveal Global Consulting, LLC is seeking a Business Analyst to bridge auditors and our AI team in healthcare claims and program integrity. You will gather requirements, document workflows, and translate needs into actionable user stories and acceptance criteria.

You will manage the backlog in Jira, run Agile sprints, support UAT, and prepare user guides while keeping stakeholders informed. A federal background investigation is required. Fulton, MD onsite position.