Medical Claims Business Analyst

1 week ago


North Philipsburg, Pennsylvania, United States TEKsystems Full time

About the Job:

TEKsystems is seeking a highly skilled Medical Claims Business Analyst to join their team. This senior-level position requires extensive experience in medical claims, business analysis, and systems analysis.

Job Description:

The ideal candidate will have 5-7+ years of experience as a Business Analyst and Systems Analysis, with a strong background in medical claims (EDI 837). They will be responsible for working consultatively with clients, documenting granular requirements, and addressing all assigned client issues & requests.

Key Responsibilities:

  • Effectively work as a ClaimsXten rules development subject matter expert on client implementations of the software
  • Address all assigned client issues & requests that are generated through the Services Support Center
  • Participate or lead internal or external ClaimsXten Service Delivery Team meetings and initiatives
  • Create test plans including case scenarios that are positive and negative

Requirements:

  • 5-7+ years of experience as Business Analyst and Systems Analysis
  • Extensive experience working with Medical Claims (EDI 837)
  • Strong experience client facing with external clients and leading the requirements process
  • SQL query writing and data mapping, modeling, profiling, and warehousing skills are a plus

Benefits:

  • A competitive salary range of $75-90k
  • Flexible hours and potential to work remote
  • A fast-paced and deadline-driven environment

About TEKsystems:

TEKsystems is a growing company in one of the fastest-growing industries in the nation. They offer a dynamic work environment and opportunities for career growth.



  • North Philipsburg, Pennsylvania, United States TEKsystems Full time

    Job DescriptionJob Summary: We are seeking an experienced Medical Claims Business Analyst to join our team at TEKsystems.Key Responsibilities:Work with clients to gather and document requirements for implementing services and rule engine components.Support clients during maintenance periods, researching issues, analyzing software behavior, and remediating...


  • North Philipsburg, Pennsylvania, United States TEKsystems Full time

    Job DescriptionTEKsystems is seeking a highly skilled Senior Business Analyst with extensive experience in Medical Claims to join their team. As a Senior Business Analyst, you will be responsible for understanding client claim systems and payment policies, documenting requirements for implementing services and rule engine components, and supporting clients...


  • North Wales, Pennsylvania, United States Oxford and Associates Full time

    We are seeking a highly skilled Business Intelligence Specialist to join our team at Oxford and Associates. This is an excellent opportunity for individuals who possess a strong passion for data analysis and interpretation.About the RoleThe primary responsibility of this role will be to develop and maintain production reporting capabilities, ensuring timely...

  • IT Business Analyst

    7 days ago


    North Wales, Pennsylvania, United States AA2IT Full time

    Overview">AA2IT is seeking an experienced IT Business Analyst to play a vital role in our Chemistry, Manufacturing, and Controls (CMC) operations team. As a key member of our CMC Ops Strategic Lead team, you will be responsible for gathering, analyzing, and documenting business requirements for systems and dashboard implementation and enhancements.">Job...


  • North Philipsburg, Pennsylvania, United States Bestica Full time

    Job Overview">Bestica is currently seeking a skilled Travel Nurse to join their team. This is an exciting opportunity for healthcare professionals who are looking for a challenging and rewarding career experience.">About the Job">This full-time position involves working as a Registered Nurse in a medical-surgical setting, providing high-quality patient care...


  • North Philipsburg, Pennsylvania, United States Nationwide Therapy Group Full time

    Nationwide Therapy Group is a leading provider of travel nursing services, seeking a skilled Med Surg Registered Nurse for a 13-week assignment in Philipsburg, Montana.Job SummaryWe are committed to matching talented healthcare professionals with rewarding opportunities that meet their career goals and personal preferences. As a travel nurse with our...


  • North Philipsburg, Pennsylvania, United States Bestica Full time

    Job Opportunity:Bestica is seeking a senior med-surg registered nurse for a travel assignment in Philipsburg, Montana.About the Job:We are looking for an experienced RN with a strong background in med-surg to join our team on a 13-week travel assignment. The ideal candidate will have 2 years of experience and a passion for delivering high-quality patient...


  • North Wales, Pennsylvania, United States Mindlance Full time

    OverviewMindlance is a company that values innovation and excellence in the Chemistry, Manufacturing, and Controls (CMC) operations team. We are seeking two skilled Technical Business Analysts to play a vital role in our team.


  • North Versailles, Pennsylvania, United States Anthony Hunt - State Farm Agent Full time

    Job OverviewThis is an exciting opportunity for a skilled Customer Experience Representative to join our dynamic team at Anthony Hunt - State Farm Agent. As a Receptionist - State Farm Agent Team Member, you will play a crucial role in helping our business grow through value-based conversations and exceptional customer service.Key Responsibilities:Establish...

  • Medical Specialist

    2 weeks ago


    North Catasauqua, Pennsylvania, United States Advanced Correctional Healthcare Full time

    Job Title: Nurse Practitioner-Part-TimeLocation: Burnett County JailShift: (1) Hour EWJob Summary:At Advanced Correctional Healthcare, our goal is to provide a higher standard of business services to support medical care and behavioral healthcare.We maintain professionalism, integrity, and commitment as we solve problems and make lives easier.Essential...


  • North Wales, Pennsylvania, United States Gwynedd Manufacturing Inc Full time

    Job SummaryWe are seeking an experienced Human Resources Specialist to join our team at Gwynedd Manufacturing Inc. As a key member of our HR department, you will be responsible for administering HR processes and supporting the overall HR function.About Gwynedd Manufacturing Inc.Gwynedd Manufacturing Inc. is a leading defense contractor based in North Wales,...


  • North Wales, Pennsylvania, United States Optum Full time

    OverviewJ. Snyder Therapeutic Services, part of the Optum family of businesses, is a leading provider of behavioral health care services in North Wales, PA.We are seeking a skilled Behavioral Health Specialist to join our team and contribute to our vision of making healthcare better for everyone.Job DescriptionThis role will involve treating a wide variety...


  • North Wales, Pennsylvania, United States Total Performance Physical Therapy Full time

    Job SummaryWe are seeking a motivated physical therapist with a passion for working with athletes and active individuals. Our ideal candidate is passionate about rehabilitating injuries and improving patient lives by addressing their true impairments.This role involves delivering high-quality care to patients in a unique blend of services to optimize...


  • North Wales, Pennsylvania, United States Gwynedd Manufacturing Inc Full time

    Job SummaryGwynedd Manufacturing Inc. is seeking an experienced In-House Counsel to provide comprehensive legal advice and support to the company in various matters.About Gwynedd Manufacturing Inc.We are a leading defense contractor based in North Wales, PA, dedicated to producing high-quality products for the U.S. Department of Defense and various federal...


  • North Vandergrift, Pennsylvania, United States Cook Group Full time

    **Overview**The Cook Group Internship is a 12-week paid internship that provides hands-on experience with meaningful projects in the Medical Device Manufacturing Industry. This position includes a 401(k) option, on-site cafeteria, an assigned mentor, one-time housing stipend, capstone presentation, intern events, and more.ResponsibilitiesSupport the...


  • North Wales, Pennsylvania, United States Gwynedd Manufacturing Inc Full time

    Job SummaryWe are seeking a skilled Manufacturing Supervisor to lead our production team and drive operational excellence. This role is responsible for supervising daily manufacturing operations, ensuring adherence to safety, quality, and productivity standards.About Gwynedd Manufacturing Inc.Gwynedd Manufacturing Inc., a renowned defense contractor located...


  • North East, Pennsylvania, United States Wavepoint3pl Full time

    At Wavepoint 3PL, we pride ourselves on delivering customer-driven solutions that adapt to the ever-changing market landscape. Our legacy spans over four decades, and our journey has been shaped by a relentless pursuit of innovation and excellence. We offer a unique blend of single-source logistics capabilities, responsiveness, and competitiveness, making us...


  • North Wales, Pennsylvania, United States Volpe Enterprises Inc Full time

    Volpe Enterprises Inc Job DescriptionThe company Volpe Enterprises Inc is currently seeking an experienced Accounting Associate to join their team. This position will be responsible for a wide range of general accounting, bookkeeping, and clerical duties to support senior staff and management in reaching monthly, quarterly, and annual reporting...


  • North Wales, Pennsylvania, United States Park Creek Place of North Wales Full time

    Job SummaryWe are seeking a highly skilled and motivated Executive Director of Community Engagement to lead our sales and marketing department at Park Creek Place of North Wales. This is an excellent opportunity for a results-driven professional to make a meaningful impact in the lives of our residents and their families.ResponsibilitiesSchedule, organize,...

  • Data Analyst

    1 month ago


    North Wales, United States Oxford and Associates Full time

    Summary: The primary responsibility of a healthcare business analyst is to pinpoint problems or improvement areas within a medical facility in order to maximize that facility's performance and profit. They must assess financial activity and seek ways to manage expenses like overtime wages and the cost of supplies. Project Details: Analyzes reporting needs...

  • Business Analyst

    1 week ago


    North Haven, United States Futran Tech Solutions Pvt. Ltd. Full time

    Role: Business Analyst Client : LTTS / Medtronic Location: North Haven, CT (Onsite) 1. Around 10 of Years experience in Business Analyst role 2. Must have worked on MES domain 3. Act as liaison with internal and external partners. 4. Identify various possible business scenarios and document it. 5. Experience with effectively leading and facilitating meetings...

  • Senior Analyst

    4 weeks ago


    North Wales, United States Ludwig Business Consultants Full time

    Job DescriptionJob DescriptionLudwig Business Consultants is a cutting-edge accounting firm serving lower to mid-market clients and has been recognized as one of the Philadelphia100’s fastest-growing companies in the region for 2024. We specialize in outsourced accounting and business solutions, and we have an exciting opportunity for a Senior Analyst to...


  • North Billerica, United States Lantheus Medical Imaging Inc Full time

    Job OverviewLantheus Medical Imaging Inc is a leading provider of innovative diagnostics and targeted therapeutics. We are seeking a Quality Business Analyst - Process Improvement Specialist to join our team in Bedford, Massachusetts.

  • Business Analyst

    4 weeks ago


    North Prairie, United States Toppers Pizza Full time

    BUSINESS ANALYST   Making great food that people connect over. That's our thing. We know we're not flying rocket ships to the moon or signing treaties, but we take our job seriously. We live by a set of core values that pretty much sum up everything about us. We have FUN and we LOVE what we do! Our goal is to be the best pizza company in the WORLD by...

  • Business Analyst

    2 weeks ago


    North Prairie, United States Toppers Pizza Full time

    BUSINESS ANALYST   Making great food that people connect over. That's our thing. We know we're not flying rocket ships to the moon or signing treaties, but we take our job seriously. We live by a set of core values that pretty much sum up everything about us. We have FUN and we LOVE what we do! Our goal is to be the best pizza company in the WORLD by...

  • Business Analyst

    1 week ago


    North Chicago, United States Spectraforce Technologies Full time

    Role: Business Analyst Duration: 5+ months Location: Chicago, IL(Hybrid)Top 5 Skill sets: 1. Experience in Agile methodology, including writing of technical user stories and acceptance criteria 2. Proficiency in Azure DevOps (ADO) or equivalent tools 3. Translating data models and process models into user stories and acceptance criteria 4. Proactively...

  • SAP Business Analyst

    1 month ago


    North Charleston, United States Equiliem Full time

    Our client is looking for an SAP Business Analyst in the North Charleston SC area. Job Summary The SAP Business Analyst position and works with business units' representatives to understand business needs, facilitate or (co-facilitate) requirements gathering sessions, investigates solutions, and helps with cost benefit analysis, to ensure the best option is...


  • North Wales, United States Joulé Full time

    Job Title: CMC Operations Business Analyst Location: North Wales, PA Hours/Schedule: Mon- Fri 8am- 5pm Type: Contract Overview Global Vaccine Manufacturer looking to add experienced Operations Business Analyst to their growing team! Responsibilities We are seeking two skilled Technical Business Analyst to play a vital role in our Chemistry,...

  • Business Analyst IT

    1 week ago


    North Wales, United States AA2IT Full time

    Title: Business Analyst Location: 351 North Sumneytown Pike, North Wales, PA Pharmaceutical /CMC Background is highly preferred.Qualifications: We are seeking two skilled Technical Business Analyst to play a vital role in our Chemistry, Manufacturing, and Controls (CMC) operations team. The ideal candidate will support the Strategic Operation leads and...


  • North Oaks, United States Harbinger Partners Full time

    Job Title: Senior Technical Business AnalystDivision: MinnesotaRole Alignment: Business Analysis Project ManagementStatus: Open| |Senior Technical Business Analyst This person ensures that applications in development are system tested and partners in the creation and execution of functional test plans. This position assists with interpreting business...

  • Business Analyst IT

    1 week ago


    North Wales, United States Manpower Group Inc. Full time

    Our client, in Pharmaceutical Industry is seeking a Business Analyst to join their team. The ideal candidate will have Pharmaceutical Industry experience, System implementation and change management experience which will align successfully in the organization. Job Title: Business Analyst IT - II Duration: 12 Month Contract Location: Hybrid role at North...


  • North Andover, United States Xfact Full time

    xFact, Inc. is a rapidly growing company serving various Government agencies. We are a team of passionate and driven individuals who are committed to building innovative products and services. Join our dynamic team and be part of our innovative and collaborative work environment.THIS IS A HYBRID ROLE, LOCAL CANDIDATES PREFERRED!Senior Business AnalystJob...


  • North Andover, United States xFact, Inc. Full time

    xFact, Inc. is a rapidly growing company serving various Government agencies. We are a team of passionate and driven individuals who are committed to building innovative products and services. Join our dynamic team and be part of our innovative and collaborative work environment.THIS IS A HYBRID ROLE, LOCAL CANDIDATES PREFERRED!Senior Business AnalystJob...


  • North Andover, United States xFact, Inc. Full time

    xFact, Inc. is a rapidly growing company serving various Government agencies. We are a team of passionate and driven individuals who are committed to building innovative products and services. Join our dynamic team and be part of our innovative and collaborative work environment.THIS IS A HYBRID ROLE, LOCAL CANDIDATES PREFERRED!Senior Business AnalystJob...

  • Business Analyst, Sr

    3 weeks ago


    North Palm Beach, United States Robert Half Full time

    Job DescriptionJob DescriptionWe are offering a long term contract employment opportunity for a Business Analyst, Sr located in Juno Beach, Florida. This role is pivotal in conducting complex operational analyses and leading medium to large project teams that support informed decision making within our business unit. Responsibilities:• Lead project teams...

  • Treasury Analyst

    1 month ago


    North Lexington, United States Robert Half Full time

    Job DescriptionJob DescriptionWe are currently seeking a Treasury Analyst to join our team in Lexington, Massachusetts. This role is an integral part of our team, providing essential support for our banking administration and investment activities. As a Treasury Analyst, you will also be responsible for ensuring compliance with treasury controls and for...


  • North East, United States JointHire Singapore Pte Ltd Full time

    Job Title: Senior Business Development ExecutiveIndustry: Healthcare / MedicalSalary: SGD 3500 - 4500Location: North East, SingaporeAbout Company:Our client being the key player in AHA/PHA skincare technology, has been harnessing the challenges and opportunities of the business to make it all happen. Since its inception in 1995, the company has been...


  • North Richland Hills, Texas, United States Federated Mutual Insurance Co Full time

    Here at Federated Mutual Insurance Co, we're seeking a highly skilled Claims Resolution Specialist to join our team!This role involves working closely with policyholders, physicians, attorneys, contractors, and other stakeholders to ensure claims are resolved in a prompt, fair, and courteous manner.Key Responsibilities:Explain policy coverage to...


  • North Chicago, United States Zifo Full time

    Location: North Chicago, IL **This will be a hybrid role and require 3-4 days on-site at our client in North Chicago** **This role is not eligible for relocation assistance** Zifo is looking for a Senior Business Analyst to add to their team in the North Chicago area. The individual will be responsible to coordinate and support strategic projects for R&D...