Requirements Analyst - Healthcare Claims Pre-Adjudication

Up to $60

Full Time

  • Work from home
  • No Travel Required

Skills

Requirements AnalysisClaims AdjudicationHealthcareSQL834837User StoriesAgile

Job Description

HEALTHCARE CLAIMS BUSINESS ANALYST (Claims Pre-Adjudication)

 

ALTA IT Services has a contract to hire or long-term contract opening for a Healthcare Business Analyst to support a leading, Washington DC area health insurance customer. This is a 100% remote position ongoing.

 

Qualified candidates must have strong healthcare claims processing experience as a business/systems analysis supporting Agile projects, performing requirements gathering, writing libraries, user stories, and articulating business needs. Candidates must be well versed in working on a scrum team, displaying superior written and verbal skills, detail orientation, independent work habits and leadership skills.

Candidates MUST demonstrate strong working knowledge related to 837, 834 transaction sets, including the differences between specific requirements documents, claims and SQL's.

As a Business Analyst, you will analyze complex business problems and evaluate the practicability of proposed enhancements and system automations. As an ideal candidate you will collect and synthesize data, review current business processes, understand end-user needs in consultation with stakeholders and explain implications. Acts as a liaison between business users and IT development team. Business Analyst work closely with Subject Matter Experts (SME) to create and update Libraries/User Stories, Change Management Summaries and Use Cases.

RESPONSIBILITIES

  • Conducts interviews with the business area, analyzing their IT needs to develop descriptions of moderately complex systems proposals.
  • Prepare, review, revise and maintain Libraries/User Stories and Change Management Summaries related to business and user requirements.
  • Develop software requirements specifications that captures the complete system and serve as the "build-to" specification for development.
  • Serve as primary liaison between the technical team, product team and end-users for the purpose of establishing a common understanding of requirements and the as-built product.
  • Develop system Use Cases that describe the system’s intended functional behavior and serve as a SME/Product Analyst.
  • Create supplementary specifications that capture system requirements that are not readily captured in Use Cases.
  • Define system quality, operational attributes, external interfaces, constraints, rules and other non-functional requirements.
  • Perform requirements modeling and diagram flows which depict various perspectives of the system’s functional behavior.
  • Provide authoritative understanding of the systems implementation independent behavior to support the following:
    • Test designers in the development of software test plans and test cases.
    • Solution architects in the development of architecture and design models.
    • Data designers in the development of logical and physical data models.
  • Serve as the development team representative during UAT for the purpose of clarifying the intended functional behavior of the software.
  • Manage requirements traceability to include development of requirements traceability matrices.
  • Triage support during software releases, which includes identification of relationships and dependencies between requirements, and estimation of technical effort.

 

QUALIFICATION REQUIREMENTS:

  • Bachelor’s degree in Information Technology, Computer science, Business, or equivalent relevant work experience as a Business Analyst.
  • Proven ability to quickly learn and understand complex topics.
  • Previous experience writing documentation and procedural materials for multiple audiences.
  • Strong experience owning end-to-end documentation creation process.
  • Experience in the health insurance industry.

 

REQUIRED ABILITIES/SKILLS:

  • Capability to use industry standard requirements gathering and modeling techniques to understand and communicate the needs of the product’s user.
  • Ability to adapt quickly to new processes and standards, with a strong commitment to providing excellent customer service.
  • Superior written and verbal communications skills, with a keen eye for detail.
  • Strong analytical and problem-solving skills
  • Ability to work independently and as part of a team.
  • Highly developed interpersonal skills.
  • Excellent organizational skills and the ability to set priorities and handle multiple tasks concurrently.
  • Proficient PC and business solutions software skills.

 

PREFERRED QUALIFICATIONS:

  • Well-developed functional and business knowledge of Salesforce.
  • Experience working as part of a Scrum team.
  • Expertise with requirements management tools: Confluence, JIRA
  • Familiarity with SharePoint.

HOURLY RATE: $60/HR. Range. Benefits available

 

For consideration, please contact Melissa McNally via mmcnally@altaits.com

 

ALTA IT Services is a wholly owned subsidiary of System One, a leading provider of specialized workforce solutions and integrated services. ALTA is an established leader in IT Staffing and Services, for both government and commercial enterprises across the United States, specializing in Program & Project Management, Application Development, Cybersecurity, Data & Advanced Analytics, and Agile Transformation Services. We are an equal opportunity/affirmative action employer and considers qualified applicants for employment without regard to race, gender, age, color, religion, disability, veteran status, sexual orientation, or any other factor.