Senior Business Systems Analyst

Job Summary

Senior Business Systems Analyst, a full-time position focused on Provider Network Pricing for Medicare Advantage, is responsible for leveraging expertise in claims and provider pricing to develop solutions, collaborate across teams, and optimize processes within complex systems.

Key Responsibilities

• Provide support and analysis for network pricing and system/application issues
• Coordinate user support and resolve production support issues while documenting activities
• Lead projects and initiatives, ensuring business requirements are met and testing strategies are effective

Required Qualifications

• Bachelor's degree or advanced degree (where required)
• 5+ years of experience in a related field, or 7+ years in lieu of a degree
• Intermediate expertise with Facets, NetworX, and Optum is a plus
• Understanding of CMS (Medicare) guidelines and provider contractual terms
• Familiarity with UB04 and HCFA1500 billing practices