Business Systems Analyst Job at VDart Inc, Remote

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  • VDart Inc
  • Remote

Job Description

Job Title: Business Systems Analyst


Location: Remote (PST)


Job Type: Contract



Job Description:

  • Primary duties may include, but are not limited to:
  • Conducts end-to-end analysis of payer and provider workflows involving Availity transactions including Eligibility & Benefits (270/271), Claims Status (276/277), Prior Authorization (278), Attachments, and Claims (837/835).
  • Evaluates business requirements, integration patterns, and data flows to ensure alignment with Availity capabilities and enterprise-level operational expectations.
  • Reviews Availity response data, error codes, payer-specific rules, and transaction-level exceptions to validate accuracy, completeness, and adherence to EDI standards.
  • Supports implementation, enhancement, and optimization of Availity portal features, API integrations, and clearinghouse configurations.
  • Leads requirement-gathering sessions with operations, product teams, and technical stakeholders; documents functional requirements, user stories, acceptance criteria, and workflow diagrams.
  • Assesses business impact of Availity-related changes, EDI mapping updates, and upstream/downstream process modifications.
  • Performs root cause analysis for transaction failures, rejections, eligibility discrepancies, and authorization processing issues.
  • Develops test plans, executes UAT, and validates end-to-end transaction integrity for enhancements related to Availity workflows.
  • Prepares documentation, reporting summaries, analysis logs, and communication materials for both technical and non-technical teams.
  • Conducts research and evaluation of clearinghouse rules, EDI compliance requirements, and payer implementation guides.
  • May provide SME guidance to project teams and serve as a resource for Availity operations, payer-provider transactions, and healthcare EDI standards.

Skills:

  • Direct Experience in Availability transactions including Eligibility & Benefits (270/271), Claims Status (276/277), Prior Authorization (278), Attachments, and Claims (837/835).
  • Healthcare payer business system analyst
  • SQL



Job Tags

Contract work,

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