Business Systems Analyst Job at VDart Inc, Remote

OGlxVUMzME9IcG1aaW9UbWYyRDhSamNoVWc9PQ==
  • 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,

Similar Jobs

Bureau Works

Freelance translator (remote) Job at Bureau Works

More than a translation management system With Bureau Works' context-first translation platform, localization managers, translation agencies, translators, and devs alike can translate, contextualize, and scale global experiences that get results - all backed by enterprise...

Las Vegas Petroleum

Crew Member Job at Las Vegas Petroleum

 ...service and high-quality products to travelers. As a Crew Member, you will be a vital part of our operations, creating positive experiences for our customers. Position Overview: In this role, you will engage directly with customers, assist in food preparation,... 

Rainbow

Shoe Coordinator - Morrow, GA Job at Rainbow

 ...high energy, customer oriented, fashion forward managers with a retail background to join our winning team! Job Summary: Shoe Coordinator - This is our entry level management position, which will allow you to learn our business, while giving you the skills to operate... 

Environmental and Safety Solutions, Inc.

Bilingual Construction Safety Trainer Job at Environmental and Safety Solutions, Inc.

 ...ESS-296 Job Title: Construction Safety Trainer Location: Monroe, LA About the Role: Environmental and Safety Solutions, Inc. (ESS) is seeking a highly motivated and experienced Construction Safety Trainer . The successful candidate will be responsible... 

Beast Mode Truckin

Class A CDL Dedicated Truck Driver Job at Beast Mode Truckin

 ...Beast Mode Truckin is on the lookout for dedicated Local CDL Drivers to join our dynamic team! This position offers you the opportunity to operate modern trucks while delivering freight on committed lanes. With a focus on driver satisfaction and efficient routes, you'll...