Healthcare Claims IT Lead – Business Analysis

Paycom; Minneapolis (MN); On-site; USD 90,000 - 120,000; Full time

Job summary

HealthEZ is seeking a Senior IT Business Analyst with deep healthcare claims experience to bridge Claims Operations and IT. You will translate complex claims rules into clear, testable requirements and help design and test solutions across data teams, vendors, and stakeholders.

In this role you will analyze the end-to-end claims lifecycle, review APIs and data flows, and lead requirements sessions. You’ll own traceability from requirements through testing and implementation, and support

Qualifications

• Bachelor's degree in information systems, business, healthcare administration, or equivalent.
• Five+ years of experience in healthcare claims operations, claims systems analysis, business analysis, or related role.
• Strong knowledge of healthcare claims processing and adjudication.
• Ability to translate complex claims processes and rules into clear technology requirements.
• Experience analyzing claims data, researching processing issues, and validating system outcomes.
• Experience facilitating requirements sessions across business, technical, and vendor teams.
• Working knowledge of SQL and relational data concepts sufficient to investigate issues.

Responsibilities

• Serve as an IT-based subject matter expert for healthcare claims processes, systems, data, and projects.
• Analyze the end-to-end claims lifecycle, including intake, validation, adjudication, benefits, pricing, payment, adjustments, denials, and reporting.
• Partner with Claims Operations to document business rules, exceptions, pain points, and control requirements.
• Distinguish operational, configuration, data, vendor, and application issues.
• Assess how proposed changes may affect claim accuracy, financial controls, member and provider experience, and downstream systems.
• Gather, document, validate, and prioritize business, functional, data, integration, and reporting requirements.
• Translate claims needs into user stories, process flows, business rules, data requirements, and acceptance criteria.
• Analyze claims workflows and data exchanges to identify gaps, risks, dependencies, and improvement opportunities.
• Facilitate requirements sessions and help stakeholders align on scope, ownership, priorities, and outcomes.

Skills

Bachelor's degree

Healthcare claims

SQL

Data analysis

Requirements facilitation

Communication

Education

Bachelor's degree or equivalent

Tools

Azure DevOps

Power BI

SQL Server

APIs

ETL processes

Job description

HealthEZ is seeking a Senior IT Business Analyst with deep healthcare claims experience to bridge Claims Operations and IT. You will translate complex claims rules into clear, testable requirements and help design and test solutions across data teams, vendors, and stakeholders.

In this role you will analyze the end-to-end claims lifecycle, review APIs and data flows, and lead requirements sessions. You’ll own traceability from requirements through testing and implementation, and support