Senior Business Systems Analyst, Healthcare Payments

centene; United States; Hybrid; USD 85,000 - 115,000; Full time

Benefits offered by this job

Health coverage

Retirement plan

Stock purchase plans

Tuition reimbursement

Paid time off

Job summary

Centene is seeking a Business Systems Analyst to translate complex payment integrity and claims system needs into clear, testable specs. You’ll connect operations, product, engineering, QA, and vendors to deliver reliable prepay and postpay solutions in a healthcare payer environment.

You will elicit and document requirements, map data flows, perform data validation with SQL, and coordinate testing and stakeholder communication, while mentoring junior analysts.

Qualifications

• 4–6+ years in business systems analysis.
• Experience with healthcare payer, claims, payment integrity, or fraud, waste and abuse preferred.
• Knowledge of CPT/HCPCS, ICD-10, NCCI, claim editing, and prepay/postpay review.
• Strong requirements practice with process and data-flow mapping and traceability.
• Hands-on SQL skills; familiarity with Agile and SDLC.

Responsibilities

• Elicit, analyze, document, and maintain business and functional requirements.
• Work with product owners, developers, testers, and vendors to keep backlog actionable.
• Map current and target processes and data flows, including vendor feeds.
• Use SQL and reporting tools to inspect claims, edit data, and validate results.
• Coordinate test planning, system integration and user acceptance testing.
• Communicate status, risks, and dependencies; mentor junior analysts.

Skills

SQL

Agile

Requirements elicitation

Data analysis

Stakeholder management

Data mapping

Test planning

Education

Bachelor's degree in quantitative or business discipline

Tools

Power BI

Excel

Facets

ClaimsXten

Cotiviti

Amisys

Job description

Centene is seeking a Business Systems Analyst to translate complex payment integrity and claims system needs into clear, testable specs. You’ll connect operations, product, engineering, QA, and vendors to deliver reliable prepay and postpay solutions in a healthcare payer environment.

You will elicit and document requirements, map data flows, perform data validation with SQL, and coordinate testing and stakeholder communication, while mentoring junior analysts.