Senior Application Analyst, Claims Systems

Jobtailor; Town of Florida (NY); On-site; USD 90,000 - 120,000; Full time

Job summary

Jobtailor is seeking a senior business/systems analyst specialized in healthcare claims to build reporting across the full lifecycle, reconcile data, and deliver dashboards for Operations, Finance and Client Success. You will partner with Product and Engineering to resolve data and workflow gaps, and support payer implementations.

The role requires strong SQL, BI tool experience, and deep knowledge of claims formats and clearinghouse workflows in a value-based care environment.

Qualifications

• 6+ years of systems analyst or business analyst experience.
• 5+ years of provider-side claims, revenue cycle, or data management.
• 2+ years with EHR systems, revenue cycle, and billing platforms.
• Strong knowledge of claim formats (837P) and clearinghouse workflows.

Responsibilities

• Build and maintain reporting tracking full claims lifecycle from submission to payer response.
• Create self-service tools for Operations, Finance, and Client Success.
• Reconcile data across systems for accurate claim status tracking.
• Act as SME on claims structure, clearinghouse workflows, and payer responses.
• Support complex claim issues with Product and Engineering to fix data/workflow gaps.
• Support new payer implementations including workflow setup and validation.
• Develop standardized monitoring for go-lives and payer-specific processes.
• Identify and resolve recurring submission issues.
• Partner cross-functionally to improve workflows, tools, and documentation.
• Support audits and quality reviews.
• Use provider-side claims, SQL data expertise to support reporting, analytics, and process improvements.

Skills

Advanced SQL Skills

BI Tools Proficiency

Cross-Functional Communication

Data Analysis

Claims Lifecycle Management

Education

BA/BS degree in Information Technology, Computer Science or related field

Tools

Tableau

Power BI

Metabase

Job description

• 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 a subject matter expert on claims structure, clearinghouse workflows, and payer responses
• Support complex claim issues and partner with Product and Engineering to resolve data/workflow gaps and validate fixes
• Support new payer implementations, including workflow setup and validation
• Develop standardized monitoring for go-lives and streamline payer-specific processes
• Identify and resolve recurring submission issues
• Partner cross-functionally to improve workflows, tools, and documentation
• Support audits and quality reviews
• Use provider-side claims, EHR/revenue cycle, and SQL/data expertise to support reporting, analytics, process improvements, claim corrections, workflow troubleshooting, and claims process scaling

Requirements

• BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 6 years systems analyst or business analyst experience; or any combination of education and experience providing an equivalent background
• 5+ years of experience in provider-side claims, revenue cycle, or data management
• 2+ years of experience working with EHR systems, revenue cycle, and billing platforms
• Provider-side claims experience strongly preferred
• 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
• Hands-on experience within a claims platform, including claim correction, resubmission, and configuration validation
• Experience developing reports and dashboards using BI tools such as Tableau, Power BI, or Metabase
• Ability to translate complex data into clear, actionable insights for business stakeholders
• Strong cross-functional communication skills with experience partnering across Product, Engineering, Finance, and Operations
• Experience working in value-based care environments
• Candidates from all states are welcome

Core Competencies

Demonstrates expertise in provider-side claims management, including advanced SQL skills for data analysis and reporting, along with a strong understanding of claims formats and workflows. Proven ability to partner cross-functionally to enhance processes and deliver actionable insights.

Highest-signal resume keywords

• Provider-Side Claims Experience
• Advanced SQL Skills
• EHR Systems Experience
• BI Tools Proficiency
• Cross-Functional Communication

ATS Optimization Keywords

Hard Skills

• Claims Lifecycle Management
• Data Reconciliation
• Claims Platform Configuration
• Report Development
• Workflow Troubleshooting
• Claim Correction
• Data Management
• Analytics
• Process Improvement
• Claims Process Scaling

Soft Skills

• Cross-Functional Collaboration
• Communication Skills
• Problem-Solving

Industry Keywords

• Revenue Cycle
• Clearinghouse Workflows
• Professional Claim Formats
• Value-Based Care
• Healthcare Analytics

Tools & Technologies

• Tableau
• Power BI
• Metabase