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Veracity Solutions
Business Analyst ClaimsVeracity Solutions • Boston, MA, United States
Business Analyst Claims

Business Analyst Claims

Veracity Solutions • Boston, MA, United States
1 day ago
Job type
  • Full-time
Job description

Business Analyst Claims

We are seeking an experienced Business Analyst with deep expertise in healthcare claims to support a large-scale implementation initiative. This role will focus on the implementation and optimization of 837 and proprietary claims files, ensuring accurate ingestion and processing across systems. This is a hands-on role requiring someone who can quickly step in, assess current challenges, perform root cause analysis, and drive improvements to existing claims data and processes.

Key Responsibilities:

  • Lead the implementation of EDI 837 and proprietary claims files for multiple health plans
  • Analyze existing claims data, identify issues, and perform root cause analysis to resolve ingestion errors
  • Recommend and implement changes to ensure claims are processed accurately within internal systems
  • Develop a strong understanding of business rules, core platforms, and applications supporting EDI exchanges
  • Design and support end-to-end frameworks for encounter and claims data exchanges
  • Facilitate discussions with health plans and internal stakeholders to gather and clarify requirements
  • Create and maintain detailed documentation, including business requirements, process flows, and technical specifications
  • Communicate effectively across business and technical teams to ensure alignment and delivery

Required Qualifications (MUST HAVE): Strong experience with healthcare claims processing Deep expertise in EDI transactions, specifically 837 Proven experiences implementing 837 and proprietary claims files Hands-on experience with root cause analysis and data issue resolution Ability to work independently and "hit the ground running" in a fast-paced environment

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Business Analyst Claims • Boston, MA, United States

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