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Medium because the role requires niche healthcare claims and EXLMINE experience but is a common Business Analyst title.
High because deep healthcare claims, payment integrity, and EDW experience are strongly industry-specific and less transferable.
High due to explicit 12–18 years requirement plus mandatory healthcare claims BA and technical SQL/EDW skills.
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Own the capture, documentation, and resolution of business requirements to design claims audit workflows and features in the EXLMINE™ payment integrity platform.
Collaborate with internal stakeholders and external clients to develop scalable, standardized workflows and correspondence templates within the EXLMINE application.
Perform data analysis, root cause analysis, and field-level data mapping to support operational reporting and continuous improvement of claims auditing processes.
Bachelor’s degree in computer science or related field.
12 – 18 years of total professional experience; with at least 5 years as a Business Analyst in healthcare claims or auditing industry.
Mandatory experience working with healthcare data, specifically claims data and auditing.
Authorized to work in the U.S. (strict onsite/location constraint).
Experienced in hands-on data analysis and querying healthcare databases including EHR/EMR claims for payers or providers.
Strong understanding of system architecture and software development life cycle in healthcare software environments.
Skilled in translating complex business processes into technical requirements and mapping data for reporting in large-scale, cross-divisional projects.