Healthcare System Analyst – Payer Systems

Hi,

Our client is looking for a Healthcare System Analyst – Payer Systems at Woodland Hills, CA / Mason, OH (Onsite

• )
• Kindly share your updated resume to proceed furthe
• r.Position: Healthcare System Analyst – Payer Syste
• msLocation: Woodland Hills, CA / Mason, OH (Onsit
• e)Duration: Full Time / Long Term Contra

• ct
• Job Descripti
• on:A technical system analyst with good understanding of the healthcare process flow – Eligibility & Enrollment – Provider contract pricing – Claims adjudication – Billing – Appeals and Grievanc
• es.Technical understanding of SQL and Dot net – full stack preferab
• le.knowledge of Facets platform from a developer point of view – i.e. data models, architecture, and process fl
• ow.Good experience in working with Business and technical teams to prepare system requirements and Technical and functional documen
• ts.Looking for hands-on Facets systems analyst experience, including with deep benefits + claims knowledge, strong data troubleshooting ability, and clear ownership of real production issu
• es.Benefits knowledge: Strong knowledge of eligibility, enrollment, benefit plans, coverage rules, and 270/271 transactions. Demonstrated a clear understanding of how benefits impact claims adjudicati
• on.Claims adjudication knowledge: Good understanding of claims adjudication workflows, provider pricing, claim validations, denials, remittance advice, UAT, and production support activiti
• es.Facets experience: Relevant Facets exposure across member enrollment, provider enrollment, eligibility, adjudication, and provider contracting modules. Experience appears primarily from a System Analyst perspecti
• ve.Requirements analysis: Strong requirements gathering and analysis skills. Demonstrated experience with stakeholder workshops, process mapping, business requirements, wireframes, prioritization, and translation into technical specificatio
• ns.SQL/data analysis: Comfortable using SQL for root cause analysis, data validation, troubleshooting, and UAT support. Demonstrated a structured approach to investigating data issu
• es.Production issue investigation: Provided a solid example of investigating eligibility-related production issues, performing RCA, coordinating with ETL teams, and driving resolution while communicating effectively with business stakeholde
• rs.Agile/SAFe experience: Experience working in Agile/SAFe environments and using Azure DevOps for backlog and sprint manageme
• nt.Communication and documentation examples: Demonstrated strong stakeholder communication and documentation experience, including BRDs, workflow diagrams, data mapping documents, UAT artifacts, release notes, and defect tracki

• ng.
• Looking forward for your re

ply.