Business Systems Analyst (Provider, Hospitals, Revenue Cycle, Claims)
We are seeking a Sr. Business Systems Analyst (BSA) to support the Revenue Cycle and Claims domain for a hospital (Provider) ecosystem. The ideal candidate will play a pivotal role in analyzing data flows, understanding business processes, and delivering technology solutions that enhance operational efficiency across Registration, Scheduling, Billing, and Accounting.
- Key Responsibilities:
- Collaborate with stakeholders to gather, define, and document both current and future business and data needs.
- Perform data mapping of clinical, revenue cycle, and claims information into normalized models for Hospital Revenue and Claims data.
- Act as a subject matter expert (SME) on revenue cycle domains (e.g., Registration, Scheduling, Billing).
- Support data-driven use cases by building robust and scalable data concepts.
- Conduct data validation and quality testing to ensure standards compliance and accuracy.
- Evaluate existing business processes and recommend changes aligned with system integration goals.
- Participate in solution design and implementation across multiple platforms and teams.
- Conduct financial analysis including ROI to prioritize and fund projects.
- Support cross-functional teams to optimize workflow consistency and quality.
- Stay current with healthcare industry trends and apply them to improve processes.
- Identify improvement opportunities, providing actionable recommendations.
- Monitor project tasks to ensure timely delivery, scope alignment, and quality compliance.
- Proactively escalate unresolved project or process challenges.
- Required Qualifications:
- Min of 10 years of IT experience as a Business Systems Analyst, or Data Product Owner
- Minimum 3 years of experience in a Provider (Hospital) environment for Revenue Cycle or Claims analyst role within a hospital setting.
- Solid understanding of clinical, billing, and claims workflows in both ambulatory and acute care settings.
- Familiarity with data from EMRs, Revenue Cycle, and Patient Accounting Systems.
- Working knowledge of relational databases; SQL experience highly preferred.
- Bachelor s or Master s degree in IT, Computers, Health Informatics, Bioinformatics, Finance, or a related field.
- Proven ability to work independently, prioritize effectively, and deliver results under pressure.
- Experience conducting ROI or financial analysis for healthcare technology projects.
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