Role Description
This is a full-time remote position that can be located anywhere in the U.S.
The primary role of this Senior Business Systems Analyst will be to analyze complex business problems to be solved with automated systems. In this role, the Senior Business Systems Analyst is the subject matter expert for the product and a business partner to our clients and internal teams in resolving technical issues, gathering requirements, defining workflows, designing business rules, and integrating file transfers with external and internal systems.
You will leverage your advanced expertise in business analysis, healthcare workflows, agile product ownership, and requirements engineering to lead complex product initiatives and drive quality improvements across our medical billing software serving both Workers' Compensation and Auto lines of business.
The Senior Business Systems Analyst will be responsible for working directly with the Product Management and Product Development teams and may be required to lead cross-functional linked teams to address business or systems issues. This is a highly collaborative role that emphasizes quality and great customer experiences. Property & Casualty industry knowledge is an important factor for interpreting and addressing client needs within the context of our application suite.
Key Responsibilities
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Lead comprehensive requirements analysis for Workers' Compensation and Auto medical bill review workflows, complex fee schedule configurations, and multi-state regulatory compliance across both lines of business.
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Design and document advanced solution specifications for data integration processes including inbound and outbound data feeds, file-based exchanges, and real-time system-to-system connectivity.
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Architect and validate sophisticated business requirements for real-time medical provider data exchange, eligibility verification systems, and claims processing workflows across Workers' Compensation and Auto medical billing.
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Lead requirements gathering initiatives for structured file processing (CSV, XML, JSON, flat file), data transformation specifications, and end-to-end transaction processing across multiple trading partners.
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Develop innovative documentation standards and methodologies for medical billing validation, complex CPT/ICD coding scenarios, system integration specifications, and regulatory compliance requirements.
Qualifications
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Education: Bachelor's degree in computer science or related field
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Experience: Minimum 5+ years of business systems analysis experience with demonstrated expertise in healthcare, medical billing, Workers' Compensation, or Auto insurance systems
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Technical Translation: Ability to translate business requirements to pseudo-technical specifications
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Agile Product Ownership: Expert-level experience in agile/scrum environments as a product owner or senior BA, with proven ability to own and prioritize product backlogs, lead sprint planning, and guide development teams
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Database & SQL: Strong proficiency in writing SQL queries (queries, stored procedures, selects, updates, SSIS) for data analysis, requirements validation, and system investigation across relational databases
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Technical Documentation: Demonstrated ability to create comprehensive technical specifications, process flows, data mapping documents, and integration requirements using tools such as Jira, Azure DevOps, or Confluence
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Data Integration Expertise: Deep understanding of data integration patterns, structured file processing (CSV, XML, JSON, flat file), data transformation requirements, and compliance validation across multiple trading partners
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Healthcare Domain Knowledge: Strong understanding of medical billing processes, CPT/ICD/HCPCS coding complexities, and casualty insurance medical management across Workers' Compensation and Auto lines of business. Property and Casualty or Healthcare industry knowledge highly preferred
Benefits
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Medical, Dental, Vision
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Health Savings Accounts / Flexible Spending Accounts
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Life and AD&D Insurance
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401(k)
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Tuition Reimbursement
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An array of resources that encourage a lifetime of healthier living
Benefits eligibility may differ depending on full-time or part-time status. Compensation depends on the applicable US geographic market. The expected base pay for this position ranges from $80,000 - $100,000 annually, and will be based on a number of additional factors including skills, experience, and education.
The Company is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.
Don’t meet every single requirement? Studies have shown that women and underrepresented minorities are less likely to apply to jobs unless they meet every single qualification. We are dedicated to building a diverse, inclusive, and authentic workplace, so if you’re excited about this role but your past experience doesn’t align perfectly with every qualification in the job description, we encourage you to apply anyway. You may be just the right candidate for this or other roles.
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