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Senior, niche healthcare-claims BA requirement and non-Tier1 brand reduce applicant density.
Requires specific healthcare claims experience and audit domain knowledge, limiting cross-industry transferability.
Strict years and mandatory healthcare claims plus SQL requirements create high shortlisting rigor.
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Own end-to-end business analysis and requirements gathering for EXLMINE™, a proprietary claims auditing payment integrity platform.
Design and document workflows, letter templates, and business processes within EXLMINE to support auditing lifecycle from data intake through reporting.
Collaborate with internal stakeholders and clients to validate opportunities, perform data analysis, and ensure solutions meet healthcare claims auditing needs.
Bachelor’s degree in Computer Science or equivalent combination of education and experience.
12–18 years total work experience; minimum 5 years as business analyst in healthcare claims or auditing industry.
Mandatory experience working with healthcare claims data and healthcare databases (EHR/EMR) for payers or providers.
Authorization to work in the U.S. required; experience in software development environment preferred.
Experienced in large-scale, complex healthcare payment integrity or claims auditing projects involving cross-divisional coordination.
Strong data analysis skills with SQL proficiency and understanding of claims payment processes at payer-provider intersection.
Comfortable working independently to design configurable audit workflows and engage with both technical teams and business stakeholders.