Senior Business Analyst

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🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $120k - $140k / year

⏰ Full Time

🟠 Senior

🧐 Business Analyst

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HealthEdge

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2005

⚕️ Healthcare Insurance

☁️ SaaS

💳 Fintech

Healthcare Insurance • SaaS • Fintech

HealthEdge is a company that specializes in providing advanced solutions for healthcare payers through its HealthRules Solutions Suite. This suite includes a comprehensive digital claims administration processing system, care management workflow solutions, and payment integrity solutions, which aim to enhance operational efficiency and improve quality of care for health plans. By leveraging integrated technology and automation, HealthEdge helps health plans eliminate data silos, increase payment accuracy, and elevate member experience, thereby transforming the healthcare landscape for better collaboration and accessibility.

📋 Description

• Leading business requirement conversations with customer and internal teams • Managing the end-to-end requirements involving all the stakeholders • Responsible for developing business and functional requirements for Claims, Enrollment, Provider, Authorization, Payment systems • Create solutions for current business processes using UST HealthProof’s core-admin ecosystem • Collaborate with business users, management, IT, and offshore staff • Contribute towards sprint planning, retrospective, go-live/no go-live evaluation meetings

🎯 Requirements

• 10+ years of relevant work experience in business analysis • Knowledgeable in Healthcare insurance domain (Medicare, Medicare Advantage, Medicaid, ACA or Commercial) • Experience with mapping of EDI healthcare transactions (837, 834, 835, 270/271, 276/277, 278) • Exposure to healthcare eco-systems from partners like HealthEdge, TriZetto , NASCO, Advantasure or Change Healthcare • Experience working in an onshore/offshore model is a must • Bachelor’s degree or higher in business or technical field

🏖️ Benefits

• Health insurance • Retirement plans • Paid time off • Flexible work arrangements • Professional development • Bonuses • Remote work options