Claims Business Analyst

Centivo

Claims Business Analyst responsible for triaging operational issues and leading projects in affordable healthcare environment. Collaborating with business units and external vendors to support client requirements and operational workflows.

Posted 7/31/2026full-timeRemote • New York • 🇺🇸 United StatesMid-LevelSenior💰 $80,000 - $100,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in healthcare claims analysis, project management, and operational efficiency improvements, leveraging strong analytical skills and experience with claims adjudication systems to drive successful outcomes.

Highest-signal resume keywords

Claims Adjudication ExperienceBusiness Analyst ExperienceData Analytics ProficiencyHealth Insurance Benefits AdministrationProject Management Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims AdjudicationData AnalysisOperational Issue ResolutionQuery RunningRequirements Gathering

Soft Skills

Advanced Problem-SolvingOrganizational SkillsAdaptabilityRelationship BuildingCommunication Skills

Tools & Technologies

Microsoft OfficeWeb-Based Software ApplicationsJavelinaHealthRules Payer

Industry Keywords

Healthcare ClaimsSelf-Funded EnvironmentVendor ManagementOperational WorkflowsClient Implementations

About the role

Key responsibilities & impact

As a Claims Business Analyst, you will be responsible for triaging operational issues and leading projects and tasks to completion.
You will use your claims adjudication experience and TPA background to triage operational concerns, vendor issues, and related claims issues.
Familiarity with Centivo’s claims systems (Javelina and HealthRules Payer) is preferred.
You will coordinate with all business units and external vendors during client implementations and conversions to determine requirements.
This role ensures seamless integration between internal and vendor systems to support client requirements and operational workflows.
Additionally, you will lead key projects and tasks identified to improve efficiency of Centivo’s Claim team.
This role will use data analytics and other tools to identify areas of improvement needed in the business, scope out the initiative, and then lead the project through to completion.

Requirements

What you’ll need

Candidates must have at least 5 years of experience within healthcare claims
Candidates must have 3 years of experience working as a Business Analyst
Candidates must have prior experience with highly automated and integrated claim adjudication systems
Understanding of health insurance benefits administration in a self-funded environment
Advanced problem-solving skills, with a track record of researching and resolving operational issues accurately and on time.
Highly organized and able to work independently, using sound judgment to manage priorities and make decisions.
Adapts to changes in the work environment; manages competing demands and deals effectively with frequent changes, delays, or unexpected events, including production schedule pressure.
Builds strong working relationships and influences outcomes across cross-functional teams.
Proficiency in Microsoft Office and other web-based software applications.
Skilled in running queries and analyzing data to identify trends and issues.
Excellent verbal and written communication skills — able to explain complex or technical information clearly, and to understand and interpret complex information from others, including reimbursement policy standards.

Benefits

Comp & perks

Offers Equity
Offers Bonus