Business Analyst- Healthcare Claims Configuration (Remote)

This Business Analyst position is specifically focused on claims operations, including claims processing, benefit reviews, and system configuration. The role is responsible for gathering and documenting internal and client-facing workflows tied to claims administration and benefit delivery. The analyst will review system configuration for alignment with contract and program requirementsincluding claims setup, pricing, benefits, and UAT outcomesand will work closely with subject matter experts and leadership to translate operational concepts into clear documentation, process maps, and support materials. Additional responsibilities include reviewing benefit policies and procedures for accuracy and documenting necessary updates.
• 100% Remote
• Open to Direct Hire or Contract (1099)
• This role is not eligible for visa sponsorship (e.g., H-1B, TN, etc.)

Key Responsibilities:
• Meet with clients to gather operational and functional requirements, document processes, dependencies, and decision points in real time.
• Review system configuration to ensure they are meeting contract or program requirements. This may include claims, pricing, system configuration, UAT results and benefits.
• Review benefit policy and procedure documents for accuracy and incorporate updates into requirements documentation
• Collaborate with proposal teams to develop storyboards and solution frameworks aligned to government RFPs and program requirements.
• Participate in internal kickoff meetings, brainstorming sessions, and review cycles to refine solution narratives and ensure alignment with client objectives.
• Contribute to the development of SOPs, internal playbooks, staffing models, and other pre- and post-award materials.
• Serve as the central point of contact for assigned projectsfacilitating communication between clients, internal teams, and vendors.
• Assist with the development of SOPs, internal playbooks, and proposal content as needed to support contract growth or onboarding.
• Support general administration and compliance oversight, including reporting, and quality control.

Preferred Skills & Experience:
• FACETS Experience preferred.
• Previous experience in claims audit, processing, or system configurations.
• Previous healthcare experience; Government healthcare or TRICARE highly preferred.
• Comfortable interacting with internal and external stakeholders and translating client requests into business-friendly documentation.
• Experience facilitating meetings, taking detailed notes, and capturing follow-up tasks and dependencies.
• Strong time management, task tracking, and organizational skills.

Government Market Strategies is an Equal Opportunity Employer. We are committed to fostering a diverse and inclusive workplace and consider all qualified applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic under applicable law.

We also participate in the E-Verify program and will provide the Social Security Administration (SSA) and, if necessary, the Department of Homeland Security (DHS), with information from each new employee's Form I-9 to confirm work authorization.

If you require a reasonable accommodation to apply for a position or to participate in the application process, please contact HR-governmentmarketstrategies.com

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