Systems Analyst

HCSC Group; Chicago (IL); Remote; USD 70,000 - 126,000; Full time

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

Analytical skills

Problem solving

Communication skills

SQL

APIs

REST services

Agile delivery

Education

Bachelor's degree in CS/IT/Healthcare Informatics

Tools

Healthcare data platforms

APIs

REST services

Job description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Are you passionate about solving complex business problems through technology? Do you thrive at the intersection of healthcare, analytics, and systems design? Join our Payment Integrity Product team and help drive solutions that improve claims accuracy, reduce unnecessary healthcare costs, and strengthen operational efficiency across the organization. As a Systems Analyst, you will play a key role in designing, enhancing, and supporting technology solutions that enable payment integrity initiatives, improve claims adjudication accuracy, and deliver measurable business value. You will collaborate with Product Owners, Business Analysts, Architects, Developers, and Operations teams to translate complex business needs into scalable, high-performing technology solutions.

NOTE: This is a WFH role. Sponsorship is not available including if you are currently on OPT.

Required Job Qualifications

• Bachelor's degree in Computer Science, Information Technology, Healthcare Informatics, or a related field.
• Experience supporting Payment Integrity, Claims Processing, Claims Adjudication and Healthcare Payer operations.
• Working knowledge of healthcare claims platforms, provider reimbursement methodologies, coding systems (ICD, CPT, HCPCS), and payment policy implementation.
• Experience translating business and operational requirements into detailed technical specifications, system designs, and solution documentation.
• Familiarity with payment integrity programs such as pre-pay and post-pay edits, clinical editing, fraud, waste and abuse detection, and reimbursement accuracy initiatives.
• Experience working with large healthcare data sets and analytics platforms to identify trends, measure savings, and support payment accuracy initiatives.
• Knowledge of cloud-based technologies, SaaS platforms, APIs, REST services, and system integration patterns.
• Experience supporting Agile delivery teams and collaborating with Product Owners, Business Analysts, Architects, and Operations teams throughout SDLC.
• Strong analytical and problem-solving skills with the ability to assess complex business issues and recommend effective technology solutions.
• Ability to manage production support activities, troubleshoot application issues, and drive resolution of operational incidents impacting claims processing and payment integrity outcomes.
• Experience with SQL, data analysis, reporting, and healthcare data warehouses preferred.
• Excellent written and verbal communication skills with the ability to influence stakeholders across business and technology organizations.
• Knowledge of healthcare payer operations and Blue Cross Blue Shield business processes is highly desirable.

Preferred Job Qualifications

• Critical thinker who enjoys solving complex business and technical challenges.
• Can effectively bridge the gap between business needs and technical solutions.
• Comfortable navigating ambiguity and driving outcomes in a fast-paced environment.
• Have a passion for leveraging technology to improve healthcare payment accuracy and affordability.
• Thrive in highly collaborative environments and excel at building strong partnerships across teams.

This is an opportunity to work on high-visibility initiatives that directly impact healthcare affordability, claim accuracy, and member experience. You'll be part of a collaborative product organization focused on innovation, continuous improvement, and delivering meaningful outcomes for our customers, providers, and members.

If you're looking to make a measurable impact while advancing your career in healthcare technology and payment integrity, we'd love to hear from you.

Compensation: $69,800.00 - $125,900.00

Exact compensation may vary based on skills, experience, and location

HCSC Employment Statement

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. We are a drug-free and smoke-free workplace. Employment may be contingent upon successful completion of drug screening in accordance with applicable law.

To learn more about available benefits, please click https://careers.hcsc.com/totalrewards