Systems Analyst Healthcare Eligibility & EDI - 270,271.
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.
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