Systems Analyst Healthcare Eligibility & EDI

Systems Analyst Healthcare Eligibility & EDI
Duration: 12-Month Contract | Right-to-Hire After 6 Months

Position Overview

A large national healthcare technology organization is seeking a Senior Systems Analyst to support complex eligibility, benefits, and transaction-processing systems. This role supports health IT product development, EDI transaction processing, Agile delivery, testing, documentation, and collaboration with product teams and development teams.

Key Responsibilities:

Product, Requirements, & Agile Support

• Work with product owners to capture detailed requirements and translate them into user stories with complete acceptance criteria.
• Participate in Agile ceremonies and assist sprint teams in delivering high-quality increments.
• Conduct analysis sessions, user research, and usability reviews.
• Maintain Agile lifecycle tools (e.g., Jira, Confluence).

Healthcare Eligibility & EDI Transaction Analysis

• Support healthcare eligibility and benefits systems with a focus on complex business processes.
• Analyze and process EDI X12 transactions, including 270/271.
• Perform system analysis related to healthcare benefits and eligibility workflows.
• Work with cross-functional teams to troubleshoot and enhance system functionality.

Testing & Quality Assurance

• Perform software testing and validation for new features, enhancements, and fixes.
• Create and maintain test cases aligned with user story requirements.
• Support quality assurance activities within Agile teams.

Documentation & Communication

• Develop and update SOPs, system documentation, technical guides, and process materials.
• Track meeting action items, risks, timelines, milestones, and project deliverables.
• Prepare clear and concise communication materials for various stakeholders.

Project Coordination & Stakeholder Engagement

• Assist with scope definition, planning, scheduling, and tracking activities across initiatives.
• Collaborate with internal and external partners on requirements, execution, and continuous improvements.
• Engage with development and QA teams to ensure technical alignment with business needs.

System Support

• Provide operational and analytical support for eligibility and transaction-processing systems.
• Work directly with senior developers for system validation, troubleshooting, and enhancement support.

MUST-HAVE REQUIREMENTS

Must have 3 5+ years of experience supporting product development and quality assurance of health IT products (ie; as a product analyst or business analyst) working closely with Product Owner.

• Minimum Education: Must have Bachelor s Degree.
• Must have experience with Agile delivery management working with Sprint teams to implement solutions in line with product requirements and using agile collaboration tools (Jira, Confluence, etc.).
• Must have software testing experience.
• Experience with Agile or SAFe frameworks is preferred.
• Must have demonstrated abilities to analyze complex business processes and operations; represent user needs as user story requirements; and identify gaps and come up with improvements.
• Must have demonstrated ability to exercise creative and critical thinking to identify and evaluate alternatives toward arriving at decisions with stakeholders.
• Must have excellent oral and written communication skills and ability to document complex problems in a simple & intuitive manner that others can understand.
• Must have experience with Electronic Data Interface (EDI) processing.
• Must have experience with transactional systems including a systems process 270/271 transactions and/or other X12 data formats.
• Must have knowledge of Medicare policies, programs, systems and data.
• Must have experience with healthcare benefits and eligibility, specifically Medicare/Medicaid.
• Must have certifications relevant to product analyst roles (ie; Product Owner certifications or Project Manager certifications).

Tech Skills

• Cloud/Hosted environments (AWS).
• Senior Analyst must provide maintenance support to eligibility and transaction systems.
• Senior Analyst will work closely with senior developers.