Claims Business Analyst (Remote)

BeneSys, Inc. Remote
business analyst analyst remote business analyst analyst analysis stakeholders agile waterfall remote operations written verbal communication
Claims Business Analyst (Remote)


The claims business analyst has accountability to perform critical analysis supporting claim operations division and organizational initiatives which vary in complexity. The claim business analyst is responsible enterprise analysis, system conversion and any other project in which claim impacts inter-related initiatives. This role requires a strong understanding of complete end to end claim processes and policies, assist business stakeholders in making informed decisions related to claim operations. Must have strong written and verbal communication skills which are critical for this role.

Claims Business Analyst Primary Responsibilities:

  • Must demonstrate competency ability to find efficiencies and improve processes.

  • Develop and maintain reporting and analytical efforts to identify issues and trends within the department.

  • Proven ability to determine systemic process faults and improve overall process performance across the organizations.

  • Understanding of claims adjudication, particularly in a carrier or TPA environment.

  • Responsible for outlining processes and gathering/writing requirements (Hybrid, Agile and Waterfall).

  • Proficient in creating project roadmaps, use cases, visualizations, reports, test plans, process documents, etc.

  • Must be able to analyze data for gaps, trends, or potential risks and providing recommendations for areas of improvement.

  • Must be a liaison between cross-functional teams, various business units, stakeholders, and executives.

  • He/she will be supporting various types of projects and will be involved in all phases of the project life cycle that includes outlining processes, gathering/writing requirements in a Hybrid environment (Waterfall to Agile AND Agile to Waterfall), creating documentation/visualizations, defining use cases, identifying gaps/risks, making recommendations for areas of improvement, assisting in testing efforts, ensuring that deliverables are successfully executed, etc.

  • Partners with Project Manager, acting as a liaison across the organization, and collaborating with stakeholders, therefore, must be able to present to an executive-level audience.

Claims Business Analyst Qualifications

Required Qualifications:

  • Bachelor’s degree or equivalent combination of education and experience with 2 years of business process analysis preferably in health care claims (i.e., documenting business process, gathering requirements) claims payment/analysis experience. Advanced knowledge of Microsoft Applications, including Excel and Access preferred. Knowledge of managed care information systems and experience in benefits, pricing, or claims preferred.

  • Previous structured testing experience preferred.

  • Demonstrates familiarity in a variety of concepts, practices, and procedures applicable to job-related subject areas.

  • Must have strong written and verbal communication skills

Our Culture

BeneSys wants to be a great service provider to the members we serve, and we recognize we can only do that if we are also a great employer with successful employees. In short, our success is driven by our employees’ successes. We want to be a place people want to work, feel proud of what they do and feel fulfilled both professionally and personally; creating a place where employees can find long-term growth and potential.

Our culture focuses on three core values:

  • Collaboration: working together across 31 locations to achieve the best for the company and our clients.

  • Dedication: striving to create an environment where all employees work toward a common goal while committing to providing the best customer service to our members and our colleagues.

  • Integrity: doing what we say we will do. Upholding strong ethical and moral principles

Work Schedule

Full time. Monday – Friday 7:30am – 4:30pm. Remote

Competitive Benefits & Compensation Package

  • Paid Time Off (PTO)
    • 15 days of PTO during the next calendar year!

  • Medical, dental, vision, and life insurance

  • Company paid short term disability, long term disability, and AD&D insurance

  • 401k with employer match

  • Tuition reimbursement program

  • Paid training

  • Career development opportunities

  • Referral bonus for all full-time referrals

  • Competitive wages

  • Annual opportunities for increases and bonuses


Pay commensurate with education and experience.


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