Claims Analyst

Requirements

Must have:

– I require a minimum of 3 years of experience as a Business Analyst in healthcare IT projects, specifically with a concentration on claims adjudication. – A solid comprehension of Agile methodologies and prior experience working on Scrum or Kanban teams is essential. – Proficiency in the following tools is necessary: – RTC (Rational Team Concert) – Jira – Rally – I seek excellent communication and stakeholder engagement abilities. – The candidate should have the capacity to work independently and manage numerous priorities.

Responsibilities:

• I will expect you to collaborate with product owners, stakeholders, and development teams to gather, analyze, and document business requirements pertaining to claims adjudication. – You will be responsible for translating business needs into concise and actionable user stories and acceptance criteria. – It’s important for you to work closely with developers and testers to guarantee requirements are properly understood and executed. – Participation in Agile ceremonies such as sprint planning, backlog grooming, and retrospectives is required. – You should utilize tools like RTC, Jira, and Rally to manage requirements, monitor progress, and support Agile workflows. – I will need you to analyze existing mainframe systems and processes to identify avenues for enhancement or modernization. – Supporting User Acceptance Testing (UAT) and validation efforts through the creation of test scenarios and assistance with defect triage will be part of your role. – You will be responsible for maintaining documentation and ensuring the traceability of requirements throughout the project lifecycle.

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Company:

This position is a long-term contract and will be performed remotely, with an expectation of 25% travel to Hartford, CT. The ideal candidate will have strong analytical skills and significant domain knowledge in claims adjudication, playing a critical role in aligning business needs with technical solutions to ensure the successful rollout of enhancements and new functionalities. Preferred skills include experience with mainframe technologies or legacy systems, familiarity with healthcare regulations and compliance standards (like HIPAA), and expertise in data mapping, process modeling, and gap analysis. This role offers a pay rate between $35.00 and $45.00 per hour for an expected workload of 40 hours per week and includes benefits such as dental, health, and vision insurance. Additionally, I would like to ask if you are open to traveling 25% of the time to Hartford, CT.