Analyst Business Sr

Looking for a Business Analyst!! Candidate must have very extensive Healthcare Background with strong experience in Claims Adjudication and EDI Transactions!!

Location: Washington DC (This is primarily a Remote role but there may be quarterly meeting onsite)

Interview Process: In person Interview at the client location in Washington DC

***Only considering H4 EAD, GC EAD, Green Card and USC Candidates***

Manager Notes:

• Taking on a pretty new project/product. Candidate will document requirements for conversational AI (Conversational AI is NOT a hard requirement)
• Highly prefer Salesforce exp and exp utilizing interfaces
• Needs to be able to own documentation from beginning to end (Basically the Lead on documentation as this will not be a group effort and will just be working with other departments).
• End to End on the documentation side as there are no pre-existing docs since this is new project.
• They work in agile methodology so exp working on a scrum team in past is ideal
• Confluence (not mandatory), Jira and SharePoint are tools that her team uses.
• This BA needs to come in with exp owning the whole project and not rely on the team.
• Candidate must have strong Claims Adjudication and EDI transactions exp

Job Description

As a Business Analyst, you will analyze complex business problems and evaluate the practicability of proposed enhancements and system automations. As an ideal candidate you will collect and synthesize data, review current business processes, understand end-user needs in consultation with stakeholders and explain implications. Acts as a liaison between business users and IT development team. Analysts work closely with Subject Matter Experts (SME) to create and update Libraries/User Stories, Change Management Summaries and Use Cases.

Objectives of this Role:

Include, but not limited to, the following -
Conducts interviews with the business area, analyzing their IT needs in order to develop descriptions of moderately complex systems proposals.
Prepare, review, revise and maintain Libraries/User Stories and Change Management Summaries related to business and user requirements.
Develop software requirements specifications that captures the complete system and serve as the "build-to" specification for development.
Serve as primary liaison between the technical team, product team and end-users for the purpose of establishing a common understanding of requirements and the as-built product.
Develop system Use Cases that describe the systems intended functional behavior and serve as a SME/Product Analyst.
Create supplementary specifications that capture system requirements that are not readily captured in Use Cases.
Define system quality, operational attributes, external interfaces, constraints, rules and other non-functional requirements.
Perform requirements modeling and diagram flows which depict various perspectives of the systems functional behavior.
Provide authoritative understanding of the systems implementation independent behavior to support the following:
o Test designers in the development of software test plans and test cases.
o Solution architects in the development of architecture and design models.
o Data designers in the development of logical and physical data models.
Serve as the development team representative during UAT for the purpose of clarifying the intended functional behavior of the software.
Manage requirements traceability to include development of requirements traceability matrices.
Triage support during software releases, which includes identification of relationships and dependencies between requirements, and estimation of technical effort.

Qualification Requirements:
Bachelors degree in information technology, Computer science, Business or equivalent relevant work experience as a Business Analyst.
At least 3-4 years of experience working with relational databases to facilitate programming software.
3+ years of experience with Technology Architecture (Client Server and Web), project planning and estimating, systems analysis and assessment.
Proven ability to quickly learn and understand complex topics.
Previous experience writing documentation and procedural materials for multiple audiences.
Strong experience owning end-to-end documentation creation process related to day-to-day assignments and projects.
Experience with 834 (Benefit enrollment), 835 (Payment/remittance advice), 837 (Health care claim).
Experience in the health insurance industry.
Knowledge of healthcare claims processing.

Required Abilities/Skills:
Capability to use industry standard requirements gathering and modeling techniques to understand and communicate the needs of the products user.
Ability to adapt quickly to new processes and standards, with a strong commitment to providing excellent customer service.
Superior written and verbal communications skills, with a keen eye for detail.
2-4 years industry experience as an effective technical writer.
Strong analytical and problem-solving skills
Ability to work independently and as part of a team.
Highly developed interpersonal skills.
Excellent organizational skills and the ability to set priorities and handle multiple tasks concurrently.
Proficient PC and business solutions software skills.
In-depth knowledge and experience using SDLC with the implementation of Agile methodologies.