Remote Senior Claims Systems Analyst

The Elevance Health Companies, Inc.; Nashville (TN); On-site; USD 90,000 - 120,000; Full time

Job summary

Elevance Health seeks a Sr Application Analyst, Claims Systems to support reporting, analytics, and process improvements across the claims lifecycle. You will leverage provider-side claims, EHR/revenue cycle, and SQL expertise to turn data into actionable insights, support claim corrections, and improve workflows.

The role emphasizes building BI reports/dashboards, collaborating with Product, Engineering, Finance, and Ops, and delivering go-live monitoring for payer implementations.

Qualifications

• BA/BS degree in Information Technology, Computer Science or related field required with 6+ years of systems/BA experience.
• 5+ years of experience in provider-side claims, revenue cycle, or data management.
• 2+ years of experience with EHR systems, revenue cycle, and billing platforms.
• Strong understanding of professional claim formats (837P), remittance advice (835), and clearinghouse workflows.
• Advanced SQL skills with experience querying complex healthcare production or analytics databases.
• Experience developing reports and dashboards using BI tools (Tableau, Power BI, Metabase).
• Ability to translate complex data into clear, actionable insights for business stakeholders.
• Strong cross-functional communication with Product, Engineering, Finance, and Operations.

Responsibilities

• Build and maintain reporting to track the full claims lifecycle from submission to payer response.
• Create self-service tools for Operations, Finance, and Client Success.
• Reconcile data across systems to ensure accurate claim status tracking.
• Act as SME on claims structure, clearinghouse workflows, and payer responses.
• Support complex claim issues and validate fixes with Product and Engineering.
• Onboard new payers, including workflow setup and validation.
• Develop monitoring for go-lives and streamline payer-specific processes.
• Identify and resolve recurring submission issues and support audits.

Skills

Provider-side claims

SQL

Tableau

Power BI

Dashboards

BI tools

Education

BA/BS in Information Technology or Computer Science

Tools

Tableau

Power BI

Metabase

SQL querying

Job description

Elevance Health seeks a Sr Application Analyst, Claims Systems to support reporting, analytics, and process improvements across the claims lifecycle. You will leverage provider-side claims, EHR/revenue cycle, and SQL expertise to turn data into actionable insights, support claim corrections, and improve workflows.

The role emphasizes building BI reports/dashboards, collaborating with Product, Engineering, Finance, and Ops, and delivering go-live monitoring for payer implementations.