Healthcare Business Analyst III EDI, SQL and Encounters
About The Position
Perform analysis and interpretation to connect business needs and objectives with the assigned function. Support business initiatives through data analysis, identification of implementation barriers, and user acceptance testing of systems. Analyze user requirements, procedures, and problems to improve processes; conduct detailed analysis across multiple projects; recommend business solutions; and support successful implementations. The role also focuses on improving performance management and operational reporting for new business implementation processes, coordinating training with business units, and developing and sharing organizational best practices for business applications. The analyst diagnoses problems and identifies process redesign opportunities, formulates and updates departmental policies and procedures, and serves as the subject matter expert for the assigned function product to support operational performance. The position must comply with all policies and standards. Strong SQL writing and query development skills are strongly preferred, including creating, optimizing, and maintaining database tables for business reporting, data analysis, and operational decisions. Experience with healthcare encounters and EDI transactions—including analysis, troubleshooting, reconciliation, and end-to-end process support—is also strongly preferred. The role requires authorization to work in the United States without current or future employment-based visa sponsorship.
Requirements
- Bachelor’s degree in a related field or equivalent experience.
- At least 4 years of business process analysis experience, such as documenting business processes and gathering requirements, in the healthcare industry, or at least 3 years of managed care encounters experience.
- Experience with encounters or claims business analysis in healthcare; managed care or Medicaid experience is preferred.
- Must be authorized to work in the United States without the need for current or future employment-based visa sponsorship.
Nice To Haves
- Strong SQL writing and query development skills, including experience creating, optimizing, and maintaining database tables to support business reporting, data analysis, and operational decision-making.
- Experience with healthcare encounters and EDI transactions, including data analysis, troubleshooting, reconciliation, and end-to-end business process support.
- Knowledge of Amisys or another claims system.
- Knowledge of HIPAA transactions such as 837, 999, 824, and 277.
- SQL scripting experience.
Responsibilities
- Support business initiatives through data analysis, identification of implementation barriers, and user acceptance testing of systems.
- Identify and analyze user requirements, procedures, and problems to improve existing processes.
- Perform detailed analysis on multiple projects, recommend potential business solutions, and ensure successful implementations.
- Identify ways to enhance performance management and operational reports related to new business implementation processes.
- Coordinate with business units and departments to develop and deliver training programs.
- Develop, share, and incorporate organizational best practices into business applications.
- Diagnose problems and identify opportunities for process redesign and improvement.
- Formulate and update departmental policies and procedures.
- Serve as the subject matter expert on the assigned function product to ensure operational performance.
- Comply with all policies and standards.
Benefits
- Competitive pay
- Health insurance
- 401(k)
- Stock purchase plans
- Tuition reimbursement
- Paid time off
- Holidays
- Flexible approach to work schedules, including remote, hybrid, field, or office arrangements
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
