Senior Business Systems Analyst-Payment Integrity (Remote)

Centene Corp.; Connecticut; Hybrid; USD 87,000 - 161,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off & holidays

Flexible work schedules

Job summary

Centene Corp. is seeking a skilled Business Systems Analyst to translate complex business requirements into functional specs for Payment Integrity prepay and postpay solutions. You will work with product, architecture, engineering, and QA teams to ensure traceability and testability across Jira/Confluence.

You will analyze claims data using SQL and vendor tools, model processes, and support UAT and production defect investigations, while mentoring junior BSAs in standards and methodologies.

Qualifications

• 4–6+ years of business systems analysis experience in healthcare payer or payment integrity contexts.
• Experience with claims adjudication concepts and data analysis using SQL.
• Strong discipline in BRDs, user stories, and requirements traceability.
• Experience with Jira/Confluence and requirement management.

Responsibilities

• Elicit, analyze, and document BRDs, user stories, and acceptance criteria for payment integrity solutions.
• Partner with Product Owners, Architects, Engineering, QA, and vendors to translate needs into testable requirements.
• Analyze claims, edit, and vendor data to investigate issues and support root-cause analysis.
• Map current- and future-state processes and data flows, including vendor data feeds.
• Plan and coordinate UAT and sign-off; communicate status and risks to stakeholders.

Skills

BRD writing

User stories

Acceptance criteria

Stakeholder management

SQL

Education

Bachelor's degree in quantitative or business field

Tools

Facets

Amisys

ClaimsXten

Cotiviti

Machinify

Power BI

Excel

Job description

Centene Corp. is seeking a skilled Business Systems Analyst to translate complex business requirements into functional specs for Payment Integrity prepay and postpay solutions. You will work with product, architecture, engineering, and QA teams to ensure traceability and testability across Jira/Confluence.

You will analyze claims data using SQL and vendor tools, model processes, and support UAT and production defect investigations, while mentoring junior BSAs in standards and methodologies.