Remote Health Payor Business Analyst

HealthEdge; United States; Remote; USD 100,000 - 120,000; Full time

Job summary

HealthEdge is seeking a skilled Business Analyst to join our remote US team. You will capture business requirements for core health-plan admin processes and translate them into functional specifications for claims, enrollment, provider and payment systems.

Utilize Agile-like methods, work with onshore/offshore teams, and lead requirements sessions with customers and stakeholders to deliver value across multiple time zones.

Qualifications

• Knowledgeable in Healthcare insurance domain (Medicare, Medicare Advantage, Medicaid, ACA or Commercial).
• Experience mapping EDI healthcare transactions (837, 834, 835, 270/271, 276/277, 278).
• Experience documenting requirements or user stories and communicating to technical teams.

Responsibilities

• Lead business requirement conversations with customer and internal teams.
• Develop business and functional requirements for Claims, Enrollment, Provider, Authorization, Payment systems.
• Collaborate with development and QA teams to ensure the product meets project objectives.

Skills

Healthcare domain expertise

EDI transactions

Agile / Scrum familiarity

Communication skills

Requirements elicitation

Education

Bachelor’s degree or higher in business or technical field

Tools

SQL

XSDs

Job description

HealthEdge is seeking a skilled Business Analyst to join our remote US team. You will capture business requirements for core health-plan admin processes and translate them into functional specifications for claims, enrollment, provider and payment systems.

Utilize Agile-like methods, work with onshore/offshore teams, and lead requirements sessions with customers and stakeholders to deliver value across multiple time zones.