Senior Business Analyst Medicare & EDI Systems

Overview

Remote
$100,000 - $120,000
Full Time

Skills

Medicare EDI claims
FACETS claim platform
Member Enrollment & Collaterals testing experience

Job Details

  • Lead large and complex multi-million-dollar healthcare projects with focus on Medicare operations.

  • Perform business testing, requirement analysis, and process improvements across multiple functional areas.

  • Manage Medicare EDI claims processing on the FACETS platform.

  • Conduct provider testing using sCRED and Symplr applications.

  • Collaborate with senior management and cross-department teams to communicate project status and deliverables.

  • Develop clear presentations, documentation, and reports for business and technical stakeholders.

  • Analyze business and financial data to support decision-making and strategic planning.

  • Interpret EDI formats (837 I/P, 276/277, 270/271, 278, 834) and understand claims intake, adjudication logic, EOBs, and remittance files (835).

  • Support provider credentialing, member workflows, enrollment systems, and CMS reporting.

  • Use Agile tools like Jira/Rally and test management tools such as Zephyr.

  • Utilize SQL for data validation and testing activities.

  • Ensure projects are delivered on time with strong attention to detail and organizational discipline.

Nice to Have:

  • Member Enrollment & Member Collaterals testing experience.

  • Salesforce, Evolve/Broker platform experience.

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.