Business Analyst Claims Direct Hire

Vega Consulting Solutions, Inc. is searching for a Senior Business Analyst for a permanent job opportunity with our direct client. This position is 100% Remote based. Candidates must have 6+ years of experience within the US healthcare industry.
Must have experience with 834, 837, 820 X12 data formats and standards.

Candidates must be eligible for direct employment. Sponsorship is not available.

Prefer candidates with BCBS work experience

We are seeking a passionate, results-oriented Senior Business Analyst with Healthcare experience who can collaborate effectively with internal and external stakeholders to analyze, define and manage requirements to launch new product & services. The ideal candidate will have worked in-depth for top payers across one or more domains (Enrollment & Benefit Administration, Claims processing & Reimbursements, Member & Provider Portals/Service, Clinical & Care management, Funding & Billing, Reporting). This person must possess a blend of business and technical savvy; strong communication skills to collaborate across internal and external stakeholders.

Primary Responsibilities

• Candidates will work with business and solution owners to define and document requirements for the assigned products and services, as well as write user stories, acceptance criteria, feature description decks, process flows, manage traceability and UAT.
• Maintain a solid knowledge base of the functional capabilities of the various areas and products within the assigned product portfolio.
• Utilize Agile methods to analyze, define and document requirements and manage traceability. You will work with stakeholders and product teams to drive consensus on scope, design and implementation decisions.
• Provide analysis and impact to user and business for changes to current functionalities and applies problem solving skills to meet business needs.
• Develop and integrate requirement management to the delivery approach and schedule; you will also be responsible for product quality, project timeliness, and customer satisfaction.
• Participate in the presentation of information to customer and internal business and or IT teams.
• Creates business / product / third party vendor specifications for product integration and implementation.

Candidate Requirements:

• 8+ years of experience within the US healthcare industry.
  Must have experience with 834, 837, 820 X12 data formats and standards.
• Experience with CMS Submission Process, EDI transactions and response file processing flow
• Must have served as an SME with Health care claims experience with large clients
• Must have proven client facing skills supporting large programs
• Operations experience must have TPA/Payer experience
• Client Facing acumen, ability to lead Requirements sessions in the healthcare payer industry.
• Minimum 6-7 years of experience as a business analyst in healthcare payer industry.
• Expertise and experience in preparing High Level requirements, Use Cases, Business Requirement Documents, Functional specifications, Test strategy & cases and Traceability matrix.
• Proven ability to map business process and workflows, conducting gap analysis and documenting requirements, ensuring requirements are developed and tested.
• Excellent verbal/written communication skills; comfortable leading business and technology teams within the organization to translate business issues & requirements into technical solutions.
• Healthcare Insurance Payer in one of more of the following areas: Claims Administration, Enrollment & Eligibility, Benefit Administration, Contribution Accounting, Billing & Payment, Member, Provider and Employer facing portal/service.
• Ability to analyze problems and resolve issues through resolution quickly and methodically.
• Proficient with Word, Excel, and PowerPoint, Visio.
• Knowledge of BA/ MS project Tools, JIRA, MS Project
• Bachelor's degree or equivalent experience.
• BA Certifications and or PMP a plus.

If your back ground matches the above skill set and you are eligible for direct permanent employment, please select Apply Now and a Vega Staffing Specialist will reach out to you.