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[Remote] Business Analyst (Claims), Senior

Work from home Full-time role Hiring

Note: The job is a remote job and is open to candidates in USA. Acentra Health is dedicated to empowering better health outcomes through technology and clinical expertise. They are seeking a Senior Business Analyst (Claims) to lead the design and functionality of solutions involving complex information systems, ensuring alignment with business requirements and strategic vision.

Responsibilities

  • Elicit requirements working with customer and stakeholders
  • Demonstrates in-depth knowledge of business and technical solutioning relates to Core Claims to ensure high quality
  • Works with customers on presenting technical solutions for complex business functionalities
  • Possesses unwavering commitment to customer service and operational excellence
  • Provides customer support through leading client demos and presentations
  • Prioritizes and schedules work assignments based on the project plan, handling multiple tasks across project phases
  • Creates and modifies Business Process Models
  • Understands the overall system architecture and cross-functional integration
  • Demonstrates in-depth knowledge of business analysis relates to Provider Enrollment, Maintenance and Screening to ensure high quality
  • Possesses in-depth knowledge and is well-versed in multiple functions or capabilities
  • Uses cases, workflow diagrams, and gap analysis to create and modify requirements documents and design specifications
  • Analyzes user requirements and client business needs, leveraging expert opinion and expertise
  • Acts as the requirements subject matter expert and supports requirements change management
  • Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules

Skills

  • Bachelor's degree or equivalent experience in lieu of a degree
  • Minimum 5+ years of business analysis experience in Healthcare Domain knowledge with strong knowledge on Medicare / Medicaid Management Information System around Core Claims and/or Provider Management and Enrollment System experience
  • The Company acknowledges that practical, hands-on experience can provide skills and competencies equivalent to formal education. As such, in cases where a Bachelor's degree is typically required, the company will accept a minimum of six (6) years of directly relevant professional experience in lieu of a degree. In instances where the candidates has an Associate's degree, the company will accept a minimum of three (3) years of directly relevant professional experience in lieu of the Bachelor's degree
  • Minimum 5 years of experience on large complex project and domain knowledge of Medicare healthcare vertical
  • Strong knowledge in Medicare policies and guidelines
  • Strong knowledge in claims adjudication and validations
  • Strong knowledge in Medicare Reimbursement methodologies
  • Excellent Business Analysis Process (SDLC, documentation procedures) experience
  • Excellent customer relation skills including presentation and meeting facilitation
  • Experience facilitating and running customer facing requirements and design sessions
  • Excellent requirements elicitation and validation skill
  • Strong knowledge and proficiency in SQL, plus high-level of technical and database knowledge

Benefits

  • Comprehensive health plans
  • Paid time off
  • Retirement savings
  • Corporate wellness
  • Educational assistance
  • Corporate discounts

Company Overview

  • Acentra Health is a provider of clinical services and technological solutions to government healthcare organizations. It was founded in 1994, and is headquartered in Mclean, Virginia, USA, with a workforce of 1001-5000 employees. Its website is https://acentra.com/.
  • Company H1B Sponsorship

  • Acentra Health has a track record of offering H1B sponsorships, with 7 in 2026, 49 in 2025, 49 in 2024, 16 in 2023. Please note that this does not guarantee sponsorship for this specific role.
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