Business Analyst — Prior Authorization and Claims Operations

Job overview

The Business Analyst — Prior Authorization and Claims Operations role is mostly remote, with one day per month in the Quincy, MA office. Compensation is not specified. The role supports healthcare claims and reimbursement initiatives in a healthcare technology environment.

What you'll do

• Gather requirements and facilitate stakeholder interviews and solution-design workshops
• document business, functional and system requirements for claims, prior authorization, referrals and reimbursement
• conduct gap analysis and recommend process improvements
• collaborate with development, quality assurance and business teams
• develop and execute test strategies, scenarios and cases and support user acceptance testing
• assist with releases and post-production stabilization
• support issue analysis, vendor coordination, data analysis and reporting
• maintain process documentation, training materials and user guides.

What we're looking for

Skills & competencies

business analyst

prior authorization

claims operations

healthcare technology

mostly remote

quincy ma

monthly office visit

sql

user acceptance testing

requirements gathering

medicaid

managed care

Work arrangement

• Weekend coverage required

Why this role

Focus on prior authorization, claims processing, referrals and reimbursement; the posting describes a potentially multi-year contract and a mostly remote arrangement with monthly office attendance.

About the employer

Tier4 Group is hiring for this role. Industry: All Other Professional, Scientific, and Technical Services. Sector: 54.