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, Service Now, 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. 22 nd St, Suite 178,
Lombard, IL 60148
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