2155 IT & Software Developer jobs in the US
Healthcare Business Analyst - Data & Systems
$74,000 - 114,000
Axelon Services Corporation
Wall Street 44, Cerritos
$74,000 - 114,000
Requirements
Must:
- Bachelors degree in Healthcare Administration, Information Systems, Business, or a similar discipline.
- At least 5 years of experience as a Healthcare Business Analyst in either payer or provider settings.
- Hands-on experience with the Availity Portal and Availity APIs or clearinghouse integrations is essential.
- Strong grasp of HIPAA-compliant EDI transactions (270/271, 276/277, 278, 837, 835) and administrative healthcare processes.
- Proven experience in documenting business requirements, process flows, and rules related to eligibility, claims, and authorization.
- Familiarity with healthcare data protection regulations and payer/provider transaction protocols.
- Background in supporting business operations, compliance evaluations, or audits within a healthcare context.
- Competence in analyzing transaction data and resolving integration challenges, with the ability to interpret Availity error messages and payer communications.
- Exceptional written and verbal communication skills for producing clear documentation and effectively presenting analytical findings.
- Comfortable collaborating with diverse, U.S.-based teams and engaging directly with business stakeholders.
- Proficient in MS Word, MS Excel, JIRA, Confluence, and standard EDI/Availity reporting tools.
Responsibilities
- Conduct comprehensive analyses of payer and provider workflows involving Availity transactions such as Eligibility & Benefits (270/271), Claims Status (276/277), Prior Authorization (278), Attachments, and Claims (837/835).
- Evaluate business requirements, integration frameworks, and data flows to ensure they align with Availity capabilities and organizational operational needs.
- Review Availity response data, error codes, payer-specific regulations, and transaction exceptions for thoroughness, accuracy, and compliance with EDI standards.
- Aid in the implementation, enhancement, and optimization of Availity portal functionalities, API integrations, and clearinghouse configurations.
- Facilitate requirement-gathering sessions with operations, product teams, and technical stakeholders; document functional requirements, user stories, acceptance criteria, and workflow diagrams.
- Assess the business implications of modifications related to Availity, EDI mapping updates, and any upstream/downstream process changes.
- Execute root cause analyses for transaction failures, rejections, discrepancies in eligibility, and issues in authorization processing.
- Develop testing plans, execute User Acceptance Testing (UAT), and confirm the integrity of end-to-end transactions for Availity workflow advancements.
- Prepare documentation, reports, analysis logs, and communication materials suitable for both technical and non-technical personnel.
- Conduct research and assess clearinghouse guidelines, EDI compliance prerequisites, and payer implementation frameworks.
- Act as a Subject Matter Expert (SME) for project teams and serve as a resource for Availity operations, payer-provider transactions, and healthcare EDI standards.
Description
We are seeking a skilled Business Analyst to join our dynamic team in Cerritos, CA. In this hybrid role, you will have the opportunity to contribute to critical projects while collaborating with both business and technical stakeholders across our organization. We offer a competitive pay rate of $44.28 per hour, alongside a supportive work environment. Our team fosters innovation and engagement, positioning us at the forefront of healthcare solutions.
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How many Business Specialist jobs are in the United States?
Currently, there are 2155 Business openings. Check also: Project-Manager jobs, Product-Manager jobs, CRM jobs - all with salary brackets.
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The company with most openings is Boeing as they are hiring for 61 different Business Specialist jobs in the United States. They are probably quite committed to find good Business Specialists.
The company with most openings is Boeing as they are hiring for 61 different Business Specialist jobs in the United States. They are probably quite committed to find good Business Specialists.