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Business Systems Analyst

Business Systems Analyst

Name: Jobpe
Address: T-Hub, Plot No 1/C, Sy No 83/1, Raidurgam panmaktha, Knowledge City Rd, Hyderabad, Telangana, 500081, IN
Telephone: +91-83339-09630
Price range: Free

Ventra Health

1 - 4 years

4 - 8 Lacs

hyderabad

Posted:1 week ago| Platform:

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Skills Required

insurance healthcare operations business requirements workflow configuration us healthcare uat business analysis process improvement healthcare workflow analysis business system computer science denial management user acceptance testing rcm revenue cycle management

Work Mode

Work from Office

Job Type

Full Time

Job Description

Overview

The Business Systems Analyst will be responsible for configuring and optimizing internal billing systems that support key revenue cycle management (RCM) workflows. This role demands a strong foundation in US healthcare operations, including provider enrollment, payer contracting, government insurance programs (Medicaid and Medicare), and system rules configuration. The analyst will serve as a subject matter expert (SME) in translating business requirements into system configurations and ensuring billing platforms align with regulatory and operational needs. Success in this role requires both technical aptitude and deep healthcare domain knowledge, along with the ability to collaborate effectively with Business Analysts, Quality Analysts, and other stakeholders across implementation and operations teams.

Responsibilities

Configure and maintain billing system components to support revenue cycle processes such as claims generation, eligibility verification, provider enrollment, and payment posting.
Translate business and regulatory requirements into accurate and scalable system configurations.
Set up payer-specific rules and workflows including Medicare, Medicaid, and commercial payer guidelines.
Support provider credentialing and enrollment data setup within the system to ensure timely claims submission.
Work closely with Business Analysts to gather requirements and identify configuration solutions that align with operational goals.
Partner with Quality Analysts to validate and test system configurations prior to go-live.
Identify areas for process improvement and propose system enhancements to improve billing accuracy and operational efficiency.
Document system configurations, workflows, and processes in a clear and maintainable format.
Participate in user acceptance testing (UAT) and support training efforts as needed.
Stay informed on regulatory changes and industry trends impacting healthcare billing and payer requirements.
Perform ongoing maintenance activities within billing systems, including provider enrollment updates, annual payer contract renewals, fee schedule updates, and other configuration changes to ensure continued alignment with regulatory and operational requirements.

Qualifications

Bachelor’s degree in Healthcare Administration, Information Systems, Computer Science, or a related field (or equivalent work experience).
3+ years of experience in a healthcare business systems analyst or billing systems configuration role.
Strong experience with US healthcare revenue cycle management, including insurance verification, claim submission, payment posting, and denials management.
Familiarity with government insurance programs such as Medicare and Medicaid.
Experience configuring healthcare billing platforms or RCM systems (e.g., Epic, Athenahealth, Cerner, or other custom billing engines).

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Ventra Health

Healthcare Technology / Revenue Cycle Management

Brentwood

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Business Systems Analyst