Senior Business Analyst – Claims Module

🔥 7 minutes ago

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Conduent

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 2017

🤝 B2B

☁️ SaaS

🏢 Enterprise

🔥 Funding within the last year

💰 $93M Post-IPO Debt - Conduent on 2025-08

B2B • SaaS • Enterprise

Conduent is...

📋 Description

• Drive the claims module and process and provide domain knowledge. • Perform analysis of business requirements. • Design and develop documentation and ensure quality process while coordinating with customers. • Work in a team environment and provide guidance throughout the entire life cycle. • Responsible for meeting customer expectations and troubleshooting problems in the application. • Assist customers in implementation decisions.

🎯 Requirements

• Strong health care domain experience, good knowledge of Medicaid and Medicare. • Hands-on experience on claims processing and Adjudication processes. • Good experience in Reference code/data sets required in Claims adjudication. • Prior experience or understanding in configuring benefits or programs in claims system across various sub-systems. • Ability to run queries and perform basic system analysis (RCA etc.). • Close collaboration with the client and development team during the stages of development, conduct demos at completion of milestones, track and close feedback from demos. • Excellent written and spoken communication skills, multitasking ability based on priority tasks. • Collaboration with Dev, architecture, and Design teams to define the GUI view and platform requirements. • In-depth understanding of Claims and Claims lifecycle: Member, Provider, Claim submission (Paper and EDI X12), Adjudication, Payment Cycle (Finance), Reporting. • Familiarity with EDI X12 formats and systems like CMdS, GHS, Facets. • SQL proficiency to validate data in backend tables and validating X12 files. • Understanding of Interface Testing and data flow between systems.

🏖️ Benefits

• Health insurance coverage • Voluntary dental and vision programs • Life and disability insurance • Retirement savings plan • Paid holidays • Paid time off (PTO) or vacation and/or sick time • Career Growth Opportunities • Great Work Environment