Business Systems Analyst – Healthcare Benefits & Claims

Location: Remote
Pay Rate: $45–47/hr
Industry: Healthcare
Positions: 2

Job Description

We are seeking an experienced Business Systems Analyst (BSA) with strong healthcare payer experience, particularly in Benefits Administration, Claims Processing, Eligibility & Enrollment, and Healthcare Payer Operations.

The ideal candidate will bridge business and technology teams, translating healthcare business requirements into clear functional specifications while supporting Agile delivery, UAT, and system implementation initiatives.

Key Responsibilities

• Gather, analyze, validate, and document business and system requirements.
• Act as a liaison between business stakeholders, technology teams, developers, QA, and healthcare SMEs.
• Support healthcare benefits administration and claims processing initiatives.
• Create user stories, process flows, BRDs, FRDs, and functional specifications.
• Perform gap analysis and impact assessments.
• Support UAT planning, execution, defect tracking, and resolution.
• Collaborate with cross-functional teams in Agile/Scrum environments.
• Analyze business processes and recommend system or process improvements.

Required Skills

• 5+ years of Business Systems Analysis experience.
• Strong Healthcare/Payer domain expertise.
• Hands-on experience with:
  • Benefits Administration
  • Claims Processing & Adjudication
  • Eligibility & Enrollment
  • Healthcare Payer Operations
• Requirements gathering and process mapping.
• BRD/FRD and functional documentation.
• HIPAA and healthcare regulatory knowledge.
• EDI transactions: 834, 835, 837.
• SQL.
• Jira and Confluence.
• Agile/Scrum methodologies.
• Strong analytical, communication, and stakeholder management skills.

Preferred Qualifications

• Experience with Facets, QNXT, HealthEdge, or TriZetto.
• CBAP, CCBA, SAFe, or Scrum certification.
• Experience supporting large-scale healthcare payer technology initiatives.