Healthcare Business Analyst (with claims) - Hybrid from day 1

Overview

Hybrid
Depends on Experience
Contract - Independent
Contract - W2
Contract - 12 Month(s)

Skills

claims
healthcare
Business analyst
QNXT
salesforce
Servicenow
agile
scrum

Job Details

Role: Healthcare Business Analyst (with claims)
Location: Hybrid on site (CT, TX, IL, RI) only Locals
Mode of interview: Video to hire
Duration: 6 months to start (Contract to hire)
Valid LinkedIn & ID , and Education (on resume)
We are seeking a detail-oriented and analytical Business Analyst to support a Claims Workflow Optimization initiative. The ideal candidate will serve as a bridge between business needs and technical solutions, focusing on improving claims processes, ensuring compliance, and driving operational efficiency through workflow management platforms such as Salesforce or ServiceNow.
This role requires a strong understanding of healthcare claims, process design, and system integration in a payer environment.
Responsibilities
  • Collaborate with business stakeholders to gather, document, and validate business and system requirements.
  • Translate business needs into clear, actionable functional specifications for development and configuration teams.
  • Analyze current workflows and recommend optimizations to improve throughput, accuracy, and compliance.
  • Support testing, validation, and rollout of new or enhanced claims systems and workflow tools.
  • Partner with technology teams to ensure solutions align with business goals and regulatory requirements.
  • Contribute to Agile ceremonies and ensure documentation is maintained and up to date.
Required Skills & Experience
  • 5+ years of experience as a Business Analyst within healthcare payer organizations.
  • Strong knowledge of the claims lifecycle, including submission, adjudication, and resolution processes.
  • Experience with claims adjudication systems such as QNXT, HealthEdge, or similar platforms.
  • Proficiency with workflow management tools like Salesforce, ServiceNow, or equivalent case management systems.
  • Solid understanding of business process analysis, requirements gathering, and system documentation.
  • Excellent communication skills, with the ability to interact effectively with both business and technical teams.
  • Experience working in Agile/Scrum environments.


Thanks

John

NetStrive Consulting, LLC

450, E. 22nd St, Suite 178,

Lombard, IL 60148

Direct:

Desk No: Ext-404

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