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Systems Analyst Healthcare Eligibility & EDI - 270,271.

Remote, USA Full-time Posted 2025-11-24
Systems Analyst Healthcare Eligibility & EDI Duration: 12-Month Contract | Right-to-Hire After 6 Months Position Overview A large national healthcare technology organization is seeking a Senior Systems Analyst to support complex eligibility, benefits, and transaction-processing systems. This role supports health IT product development, EDI transaction processing, Agile delivery, testing, documentation, and collaboration with product teams and development teams. Key Responsibilities: Product, Requirements, & Agile Support • Work with product owners to capture detailed requirements and translate them into user stories with complete acceptance criteria. • Participate in Agile ceremonies and assist sprint teams in delivering high-quality increments. • Conduct analysis sessions, user research, and usability reviews. • Maintain Agile lifecycle tools (e.g., Jira, Confluence). Healthcare Eligibility & EDI Transaction Analysis • Support healthcare eligibility and benefits systems with a focus on complex business processes. • Analyze and process EDI X12 transactions, including 270/271. • Perform system analysis related to healthcare benefits and eligibility workflows. • Work with cross-functional teams to troubleshoot and enhance system functionality. Testing & Quality Assurance • Perform software testing and validation for new features, enhancements, and fixes. • Create and maintain test cases aligned with user story requirements. • Support quality assurance activities within Agile teams. Documentation & Communication • Develop and update SOPs, system documentation, technical guides, and process materials. • Track meeting action items, risks, timelines, milestones, and project deliverables. • Prepare clear and concise communication materials for various stakeholders. Project Coordination & Stakeholder Engagement • Assist with scope definition, planning, scheduling, and tracking activities across initiatives. • Collaborate with internal and external partners on requirements, execution, and continuous improvements. • Engage with development and QA teams to ensure technical alignment with business needs. System Support • Provide operational and analytical support for eligibility and transaction-processing systems. • Work directly with senior developers for system validation, troubleshooting, and enhancement support. MUST-HAVE REQUIREMENTS Must have 3 5+ years of experience supporting product development and quality assurance of health IT products (ie; as a product analyst or business analyst) working closely with Product Owner. • Minimum Education: Must have Bachelor s Degree. • Must have experience with Agile delivery management working with Sprint teams to implement solutions in line with product requirements and using agile collaboration tools (Jira, Confluence, etc.). • Must have software testing experience. • Experience with Agile or SAFe frameworks is preferred. • Must have demonstrated abilities to analyze complex business processes and operations; represent user needs as user story requirements; and identify gaps and come up with improvements. • Must have demonstrated ability to exercise creative and critical thinking to identify and evaluate alternatives toward arriving at decisions with stakeholders. • Must have excellent oral and written communication skills and ability to document complex problems in a simple & intuitive manner that others can understand. • Must have experience with Electronic Data Interface (EDI) processing. • Must have experience with transactional systems including a systems process 270/271 transactions and/or other X12 data formats. • Must have knowledge of Medicare policies, programs, systems and data. • Must have experience with healthcare benefits and eligibility, specifically Medicare/Medicaid. • Must have certifications relevant to product analyst roles (ie; Product Owner certifications or Project Manager certifications). Tech Skills • Cloud/Hosted environments (AWS). • Senior Analyst must provide maintenance support to eligibility and transaction systems. • Senior Analyst will work closely with senior developers. Apply tot his job Apply To this Job

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