Remote Systems Analyst - Healthcare Payment Integrity
HCSC Group
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Job summary
HCSC is seeking a Systems Analyst to join the Payment Integrity Product team. You will design, enhance, and support technology solutions that improve claims adjudication accuracy and drive business value.
You’ll collaborate with Product Owners, BAs, Architects, Developers, and Operations to translate complex needs into scalable, high-performing solutions. The role supports SDLC and Agile delivery, leveraging cloud-based tech, APIs, and data analytics to optimize payer operations and
Qualifications
- Bachelor's degree in CS/IT/Healthcare Informatics or a related field.
- Experience supporting Payment Integrity, Claims Processing, and payer operations.
- Knowledge of ICD, CPT, HCPCS coding and payment policy implementation.
- Experience translating requirements into detailed technical specifications and designs.
- Familiarity with pre-pay and post-pay edits, fraud, waste and abuse detection.
- Experience with large healthcare datasets and analytics platforms.
- Knowledge of cloud-based technologies, SaaS, APIs, and REST services.
- Experience with Agile delivery and collaboration across SDLC.
- Strong analytical and problem-solving skills.
- Experience with production support and incident resolution.
- Experience with SQL and healthcare data warehouses preferred.
- Excellent written and verbal communication; ability to influence stakeholders.
- Knowledge of BCBS payer operations desirable.
Responsibilities
- Design, enhance, and support technology solutions for payment integrity.
- Collaborate with Product Owners, BAs, Architects, Developers, and Operations to translate requirements into scalable, high-performing solutions.
- Deliver measurable business value by improving claims accuracy and reducing costs.
- Support SDLC and Agile delivery across the team.
Skills
Education
Tools
Job description
HCSC is seeking a Systems Analyst to join the Payment Integrity Product team. You will design, enhance, and support technology solutions that improve claims adjudication accuracy and drive business value.
You’ll collaborate with Product Owners, BAs, Architects, Developers, and Operations to translate complex needs into scalable, high-performing solutions. The role supports SDLC and Agile delivery, leveraging cloud-based tech, APIs, and data analytics to optimize payer operations and
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