Business Analyst (Reference Data)
Summary
As a Business Analyst – Healthcare Reference, you will contribute to healthcare technology delivery by analyzing business needs, documenting requirements, and supporting solutions involving healthcare reference code sets and claims data. You will act as a bridge between business stakeholders, coding/policy experts, and technical teams to translate operational needs into clear and actionable requirements.
This role is strictly involved in business analysis, requirements documentation, and healthcare reference data support activities and does not involve direct access to Protected Health Information (PHI), Personally Identifiable Information (PII), or any secured or confidential client data. The work is limited to analysis of healthcare claims, reference code sets, and system configurations using governed datasets and does not include handling or processing of sensitive health or personal information.
Your role in our mission
Having 10+ years of experience, this position will be responsible for supporting healthcare business analysis and reference‑data driven initiatives.
Analyze, design, and document business requirements related to healthcare claims, reference data, and code sets
Work with stakeholders to gather and define requirements involving ICD, CPT, HCPCS, UB‑04, revenue codes, provider taxonomy, and other healthcare reference data
Develop and maintain business analysis artifacts such as BRDs, functional specifications, process flows, decision tables, and traceability matrices
Translate business, policy, and coding requirements into clear functional objectives for technical teams
Perform impact analysis for code‑set changes, regulatory updates, and policy changes across claims processing systems
Support testing activities, including defining test scenarios and validating system outputs
Participate in technical reviews and project discussions to ensure requirement alignment across lifecycle phases
Identify opportunities for business process improvement and data governance enhancements
Collaborate with developers, testers, and stakeholders for issue resolution, defect triage, and root‑cause analysis
Communicate effectively with business and technical teams through documentation, meetings, and presentations
What we're looking for
6–10 years of experience in a Business Analyst role
Strong experience in healthcare domain (Medicaid / Medicare / claims processing)
Working knowledge of healthcare code sets, including:
ICD‑10‑CM / ICD‑10‑PCS
CPT, HCPCS
UB‑04 institutional billing elements
Revenue codes, modifiers, type of bill, place of service
Experience in requirements gathering, analysis, and documentation
Strong understanding of claims lifecycle, adjudication, and reference data workflows
Experience working with SDLC processes, testing, and system configuration concepts
Strong analytical and problem‑solving skills
Proficiency in Microsoft Excel and data analysis tools
Experience with SQL for data analysis and validation
Strong communication and stakeholder management skills
What you should expect in this role
Remote Opportunity
2 PM - 11 PM Shift Timing
As a Business Analyst – Healthcare Reference, you will contribute to healthcare technology delivery by analyzing business needs, documenting requirements, and supporting solutions involving healthcare reference code sets and claims data. You will act as a bridge between business stakeholders, coding/policy experts, and technical teams to translate operational needs into clear and actionable requirements.
This role is strictly involved in business analysis, requirements documentation, and healthcare reference data support activities and does not involve direct access to Protected Health Information (PHI), Personally Identifiable Information (PII), or any secured or confidential client data. The work is limited to analysis of healthcare claims, reference code sets, and system configurations using governed datasets and does not include handling or processing of sensitive health or personal information.
Your role in our mission
Having 10+ years of experience, this position will be responsible for supporting healthcare business analysis and reference‑data driven initiatives.
Analyze, design, and document business requirements related to healthcare claims, reference data, and code sets
Work with stakeholders to gather and define requirements involving ICD, CPT, HCPCS, UB‑04, revenue codes, provider taxonomy, and other healthcare reference data
Develop and maintain business analysis artifacts such as BRDs, functional specifications, process flows, decision tables, and traceability matrices
Translate business, policy, and coding requirements into clear functional objectives for technical teams
Perform impact analysis for code‑set changes, regulatory updates, and policy changes across claims processing systems
Support testing activities, including defining test scenarios and validating system outputs
Participate in technical reviews and project discussions to ensure requirement alignment across lifecycle phases
Identify opportunities for business process improvement and data governance enhancements
Collaborate with developers, testers, and stakeholders for issue resolution, defect triage, and root‑cause analysis
Communicate effectively with business and technical teams through documentation, meetings, and presentations
What we're looking for
6–10 years of experience in a Business Analyst role
Strong experience in healthcare domain (Medicaid / Medicare / claims processing)
Working knowledge of healthcare code sets, including:
ICD‑10‑CM / ICD‑10‑PCS
CPT, HCPCS
UB‑04 institutional billing elements
Revenue codes, modifiers, type of bill, place of service
Experience in requirements gathering, analysis, and documentation
Strong understanding of claims lifecycle, adjudication, and reference data workflows
Experience working with SDLC processes, testing, and system configuration concepts
Strong analytical and problem‑solving skills
Proficiency in Microsoft Excel and data analysis tools
Experience with SQL for data analysis and validation
Strong communication and stakeholder management skills
What you should expect in this role
Remote Opportunity
2 PM - 11 PM Shift Timing