Sr Application Analyst, Claims Systems

Elevance Health•Nashville, TN

8d•Remote

About The Position

CareBridge Health, a member of the Elevance Health family within Carelon, is seeking a Sr Application Analyst, Claims Systems professional to support reporting, analytics, and process improvements across the claims lifecycle. This role involves utilizing provider-side claims, EHR/revenue cycle, and SQL/data expertise to transform complex data into actionable insights, assist with claim corrections, troubleshoot claims workflows, and enhance processes. The analyst will build reporting solutions, improve submission performance, and collaborate with Product, Engineering, Finance, and Operations to scale end-to-end claims processes. The position is virtual, offering flexibility, with the exception of occasional in-person training sessions. Candidates must be within a reasonable commuting distance of a posting location unless an accommodation is granted.

Requirements

BA/BS degree in Information Technology, Computer Science or related field of study.
A minimum of 6 years systems analyst or business analyst experience.
Any combination of education and experience, which would provide an equivalent background.

Nice To Haves

5+ years of experience in provider-side claims, revenue cycle, or data management.
2+ years of experience working with EHR systems, revenue cycle, and billing platforms, with provider-side claims experience strongly preferred.
Strong understanding of professional claim formats (837P), remittance advice (835), and clearinghouse workflows.
Advanced SQL skills with experience querying complex healthcare production or analytics databases.
Hands-on experience within a claims platform, including claim correction, resubmission, and configuration validation.
Experience developing reports and dashboards using BI tools (e.g., Tableau, Power BI, Metabase)
Ability to translate complex data into clear, actionable insights for business stakeholders.
Strong cross-functional communication skills with experience partnering across Product, Engineering, Finance, and Operations.
Experience working in value-based care environments.

Responsibilities

Build and maintain reporting to track the full claims lifecycle from submission to payer response.
Create self-service tools for Operations, Finance, and Client Success.
Reconcile data across systems to ensure accurate claim status tracking.
Act as an SME on claims structure, clearinghouse workflows, and payer responses.
Support complex claim issues and partner with Product and Engineering to resolve data/workflow gaps and validate fixes.
Support new payer implementations, including workflow setup and validation.
Develop standardized monitoring for go-lives and streamline payer-specific processes.
Identify and resolve recurring submission issues.
Partner cross-functionally to improve workflows, tools, and documentation.
Support audits and quality reviews.