Immediate Hire : Business Systems Analyst WITH Healthcare EDI & Availity : 100% REMOTE
Aditya Jain
Hi,
We have a high-priority opening for a Business Systems Analyst
please share your resume if interested
Lead EDI Business Systems Analyst (Availity & Healthcare Payer)
- Job Title: Business Systems Analyst
- Location: Remote (PST Hours)
- Client: Cognizant / Scan Health Plan
- Request ID: 52032-1
Job Summary
We are seeking a highly specialized Business Systems Analyst with deep expertise in Healthcare EDI and the Availity ecosystem. This role is responsible for the end-to-end analysis of payer-provider workflows, specifically managing complex EDI transactions. You will serve as the bridge between business operations and technical integration teams, ensuring that eligibility, claims, and authorization data flows meet both HIPAA standards and enterprise operational requirements. The ideal candidate must be proficient in SQL for data analysis and have hands-on experience troubleshooting Availity API and portal integrations.
Key Responsibilities & Required Skills
Availity & EDI Transaction Mastery
- Workflow Analysis: Conduct end-to-end analysis of payer/provider workflows involving key transactions: 270/271 (Eligibility), 276/277 (Claims Status), 278 (Prior Auth), and 837/835 (Claims/Remittance).
- Data Validation: Review Availity response data, error codes, and payer-specific rules to validate accuracy and adherence to EDI standards.
- Root Cause Analysis: Perform deep-dive troubleshooting for transaction failures, rejections, and eligibility discrepancies.
Technical Business Analysis
- Requirement Gathering: Lead sessions with product and technical stakeholders to document functional requirements, user stories, and acceptance criteria in JIRA/Confluence.
- SQL Data Analysis: Utilize SQL to query and analyze transaction data, troubleshooting integration issues and interpreting payer communication.
- Integration Support: Support the implementation and optimization of Availity portal features and API configurations.
Compliance & Quality Assurance
- UAT & Testing: Develop comprehensive test plans and execute User Acceptance Testing (UAT) to validate end-to-end transaction integrity.
- EDI Standards: Maintain strict adherence to HIPAA-standard EDI transactions and data protection expectations.
- Documentation: Create detailed process flows, business rules, and mapping updates for upstream and downstream process modifications.
Mandatory Skills (Must be on Resume)
- Direct Availity Experience: Must show experience with 270/271, 276/277, 278, and 837/835 transactions.
- Healthcare Payer Expertise: Proven history as a BSA within the healthcare payer domain.
- SQL Proficiency: Ability to perform data analysis and troubleshooting via SQL.
Thanks,
_______________________________________
Aditya Jain | New York Technology Partners
120 Wood Avenue S | Suite 504 | Iselin NJ 08830
Email: adity...@nytpcorp.com Direct: 201-975-0212 EXT: 482
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