Systems Analyst III – Healthcare Claims

We are seeking an experienced Systems Analyst III to support healthcare claims systems and business process improvements. The ideal candidate will have knowledge of healthcare insurance, end-to-end claims processing, requirements gathering, SQL, and systems testing. This role involves collaborating with business stakeholders, developers, and QA teams to deliver effective technology solutions.

Key Responsibilities

• Analyze business needs and translate requirements into technical and functional specifications.
• Gather, document, and manage business requirements, user stories, and non-functional requirements.
• Support the development, testing, implementation, and integration of IT system solutions.
• Analyze and troubleshoot issues related to healthcare claims processing systems.
• Collaborate with business users, developers, QA teams, and Agile delivery teams.
• Perform data analysis, validation, and reporting to support business decisions.
• Translate customer journeys and business requirements into user stories and system functionality.
• Support system enhancements, process automation, and implementation planning.
• Develop recommendations to resolve system and business process issues.
• Prepare technical documentation, business cases, reports, and presentations.
• Participate in planning sessions, requirements workshops, and project prioritization activities.

Required Qualifications

• 4–6 years of relevant experience in systems analysis, solution development, testing, and implementation.
• Knowledge of healthcare insurance and end-to-end claims processing.
• Understanding of healthcare payer processes, including members, eligibility, and claims.
• Experience with requirements gathering, functional specifications, and system testing.
• Knowledge of Systems Development Life Cycle (SDLC) and Quality Assurance (QA).
• Experience with SQL and data analysis.
• Ability to translate business requirements into user stories and technical solutions.
• Knowledge of Agile methodologies and familiarity with DevSecOps and Design Thinking.
• Strong analytical, problem-solving, documentation, and communication skills.
• Ability to collaborate effectively with technical teams and business stakeholders.

Preferred Qualifications

• Bachelor's degree in Information Technology, Computer Science, Business Systems, or a related field, or equivalent work experience.
• Experience with data visualization tools and reporting.
• Experience supporting complex healthcare claims systems and enterprise IT projects.