Technical Business Analyst - Healthcare Billing

Location: Middleburg Heights, OH

Department: Integrations Team / Application Development

Reports To: Director of Application Development

Job Type: Full-Time / Hybrid

Position Summary:

We are seeking a detail-oriented and technically proficient Technical Business Analyst with expertise in healthcare billing systems to join our team. This role will serve as a critical link between business stakeholders and IT, ensuring that billing processes are optimized, compliant, and aligned with organizational goals.

Key Responsibilities:

General Business Analysis

• Gather, analyze, and document business and technical requirements.
• Translate business needs into functional specifications and user stories.
• Conduct gap analyses and recommend process improvements.
• Facilitate stakeholder meetings to define project scope and objectives.
• Support QA and UAT efforts by validating test cases and outcomes.

Technical & Systems Analysis

• Analyze system capabilities and recommend enhancements.
• Create and maintain documentation including process flows, data models, and integration maps.
• Troubleshoot and resolve system issues related to billing workflows.

Healthcare Billing-Specific Functions

• Analyze and optimize workflows related to medical billing and client specific Use Cases.
• Knowledge regarding compliance with HIPAA, CMS guidelines, and payer-specific billing requirements.
• Monitor and analyze order and claim data received from our client.
• Support integration of billing systems.
• Assist in audit and reconciliation processes by providing system data and documentation.

Reporting & Data Analysis

• Develop and maintain dashboards and reports using tools like SQL or Power BI.
• Perform data analysis to support decision-making and identify trends in billing performance.
• Ensure data integrity and consistency across systems.

Project & Change Management

• Contribute to project planning, timelines, and resource allocation.
• Support change management initiatives including training and documentation.
• Track and report on project progress, risks, and issues.
• ServiceNow event logging and verification of change control compliance

Qualifications:

Required:

• Bachelor’s degree in Business, Information Systems, Healthcare Administration, or related field.
• 3+ years of experience as a Business Analyst, preferably in healthcare or billing systems.
• Strong understanding of healthcare billing processes, coding standards (ICD-10, CPT, HCPCS), and payer requirements.
• Proficiency in SQL and data visualization/reporting tools.
• Excellent communication, analytical, and problem-solving skills.

Preferred:

• Familiarity with HL7 and JSON data structures.
• Familiarity with HIPAA and CMS compliance standards.
• Agile/Scrum experience.

Working Conditions:

Hybrid (2 days onsite per week)