Healthcare Payer Analyst: Claims, Enrollment & Billing

TechDigital Group; United States; On-site; USD 60,000 - 100,000; Full time

Job summary

An established industry player is seeking a skilled Business Analyst with a strong background in the healthcare payer sector. This role involves translating complex business needs into clear, actionable requirements and analyzing data to identify and solve business challenges. The ideal candidate will possess extensive knowledge of claims, billing, and enrollment processes, as well as a solid understanding of compliance policies. With a focus on collaboration and communication, you will work with teams to enhance business growth and ensure adherence to industry standards. If you are passionate about driving innovation in healthcare, this opportunity is perfect for you.

Qualifications

• 5+ years of experience in healthcare payer industry.
• Strong analytical skills to identify business problems and solutions.

Responsibilities

• Translate business needs into detailed requirements for new applications.
• Analyze data to determine business problems and recommend changes.

Skills

Healthcare Payor Industry Knowledge

Claims Analysis

Billing and Enrollment Platforms

Medicare and Medicaid Reporting

Risk Adjustment

Business Intelligence

Data Mapping

Analytical Skills

Communication Skills

Tools

JIRA

MS Word

MS Excel

MS Access

Job description

Mandatory Skills

• Spring Boot & Spring Cloud
• Java
• Microservices
• REST APIs
• AWS Cloud Services

JD Responsibilities

• Design, develop, and maintain backend applications using Java, Spring Boot, and Spring Cloud
• Build and enhance RESTful APIs and microservices for scalable enterprise applications
• Deploy, manage, and support applications using AWS services such as EC2, Lambda, S3, RDS, IAM, CloudWatch, and VPC
• Implement distributed system capabilities including service discovery, configuration management, API gateway, and inter-service communication using Spring Cloud
• Model, query, and optimize Oracle Database schemas, stored procedures, and SQL queries
• Implement security best practices using Spring Security, OAuth2/OIDC, and secure API design principles
• Optimize application performance, reliability, and scalability through caching, asynchronous processing, pagination, and efficient resource management
• Build and maintain CI/CD pipelines and support deployments across AWS environments
• Monitor application health using logging, metrics, tracing, and troubleshooting tools
• Participate in code reviews, technical design discussions, and cross-functional collaboration to deliver high-quality solutions
• Experience & Qualifications
• Bachelor's degree in computer science, information technology, or a related field, or equivalent practical experience
• 5–7 years of professional experience in backend development
• Must have strong hands-on experience in Java, Spring Boot, Spring Cloud, and AWS services
• Strong experience in developing REST APIs and microservices-based applications
• Hands-on experience with AWS services such as EC2, Lambda, S3, RDS, IAM, CloudWatch, and VPC
• Good understanding of Spring Cloud components such as Config Server, API Gateway, and distributed service communication
• Hands-on experience with Oracle Database, including SQL, PL/SQL, indexing, and query optimization
• Experience with CI/CD pipelines, Git-based workflows, and deployment automation

Strong problem-solving, debugging, and communication skills