Senior Business Analyst in Healthcare

American IT Systems • Atlanta, GA

2d • Remote

About The Position

We are seeking a highly experienced Senior Business Analyst with a strong background in the Healthcare industry, specifically in Medical Claims Adjudication. The ideal candidate will have a proven track record of creating detailed documentation, configuring claims-related business rules, and working with Electronic Health Records (EHR) and Electronic Medical Records (EMR) systems. This role requires a comprehensive understanding of healthcare business processes, payer-provider workflows, claims processing, and regulatory requirements. The position is fully remote.

Requirements

• 10-15 years of experience.
• Strong knowledge and hands-on experience in Medical Claims Adjudication across multiple payers.
• Experience creating functional requirements documentation such as BRDs (Business Requirements Documents) and DSDs (Design Specification Documents).
• Hands-on experience working with Electronic Health Records (EHR) and Electronic Medical Records (EMR) systems.
• Comprehensive understanding of healthcare business processes, payer-provider workflows, claims processing, and regulatory requirements.
• 2 to 5 years of experience as a Business Analyst, Systems Analyst, or related role working with information technology and business teams.
• Intermediate knowledge of requirements gathering, documentation, analysis, validation, traceability, prioritization, and change management.
• Experience with Long-Term Care (LTC), Inpatient, and Outpatient claims processing.

Nice To Haves

• Extensive experience in the Healthcare industry, with expertise in EHR/EMR platforms, Medical Claims Adjudication, and Claims Processing.
• Proven ability to gather business requirements, create detailed documentation, and work effectively with business and technical teams to deliver healthcare technology solutions.
• Strong stakeholder management, communication, and client-facing skills.

Responsibilities

• Configure claims-related business rules based on policy, business, and technical requirements.
• Gather business requirements, create detailed documentation (BRDs, DSDs), and work effectively with business and technical teams to deliver healthcare technology solutions.
• Translate high-level business requirements into detailed functional and technical requirements.
• Manage stakeholders, communicate effectively, and engage in client-facing activities.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: Associate degree