Business Analyst - Health Insurance Claims Platform

Job overview

The Business Analyst - Health Insurance Claims Platform role is listed onsite in Santa Clara, CA; compensation is not specified. The description separately identifies Kennesaw, GA 30144 as onsite, so the work location details conflict. The role supports delivery of a Claims Management Platform in a regulated health insurance environment. The analyst translates claims and eligibility processes into clear, testable business rules and requirements, connecting business stakeholders with technical delivery teams. The work supports compliant platform delivery, operational efficiency, analytics readiness, and stakeholder alignment through requirements, backlog refinement, testing, and process analysis.

What you'll do

• Maintain rules for claims data cleaning, standardization, combination, corrections, reversals, and duplicates
• own and refine the project backlog
• define record-matching and member eligibility rules
• facilitate working sessions with business and claims SMEs
• perform gap analysis
• define operational metrics
• develop requirements, user stories, acceptance criteria, and UAT scenarios
• and act as liaison between business and technical teams. The description calls for health insurance and stop-loss expertise, requirements management, stakeholder engagement, and business process analysis.

What we're looking for

Skills & competencies

business analyst

health insurance

claims management

eligibility rules

claims data

requirements management

backlog refinement

uat

hipaa

microsoft fabric

power bi

santa clara ca

kennesaw ga

Work arrangement

• Weekend coverage required

Why this role

Focuses on health insurance, stop-loss, claims data, member eligibility, and a Claims Management Platform.

About the employer

Tanisha Systems is hiring for this role. Industry: Custom Computer Programming Services. Sector: 54.