Senior Business Analyst – Claims Module

Conduent

Senior Business Analyst leading Claims Domain projects for health care at Conduent. Driving module processes, analyzing requirements, and assisting in customer implementation decisions.

Posted 7/28/2026full-timeRemote • 🇺🇸 United StatesSenior💰 $85,470 - $111,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates strong expertise in health care domain knowledge, particularly in Medicaid and Medicare, with hands-on experience in claims processing and adjudication. Proficient in SQL for data validation and familiar with EDI X12 formats, ensuring effective collaboration with clients and development teams throughout the claims lifecycle.

Highest-signal resume keywords

Health Care Domain ExperienceClaims ProcessingSQL ProficiencyEDI X12 FamiliarityClaims Lifecycle Understanding

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ProcessingAdjudication ProcessesReference Code/Data SetsSystem AnalysisInterface Testing

Soft Skills

Excellent Communication SkillsMultitasking AbilityCollaboration

Tools & Technologies

CMdSGHSFacets

Industry Keywords

MedicaidMedicareClaims LifecycleClaim SubmissionPayment CycleReporting

Tech Stack

Tools & technologies

SQL

About the role

Key responsibilities & impact

Drive the claims module and process and provide domain knowledge.
Perform analysis of business requirements.
Design and develop documentation and ensure quality process while coordinating with customers.
Work in a team environment and provide guidance throughout the entire life cycle.
Responsible for meeting customer expectations and troubleshooting problems in the application.
Assist customers in implementation decisions.

Requirements

What you’ll need

Strong health care domain experience, good knowledge of Medicaid and Medicare.
Hands-on experience on claims processing and Adjudication processes.
Good experience in Reference code/data sets required in Claims adjudication.
Prior experience or understanding in configuring benefits or programs in claims system across various sub-systems.
Ability to run queries and perform basic system analysis (RCA etc.).
Close collaboration with the client and development team during the stages of development, conduct demos at completion of milestones, track and close feedback from demos.
Excellent written and spoken communication skills, multitasking ability based on priority tasks.
Collaboration with Dev, architecture, and Design teams to define the GUI view and platform requirements.
In-depth understanding of Claims and Claims lifecycle: Member, Provider, Claim submission (Paper and EDI X12), Adjudication, Payment Cycle (Finance), Reporting.
Familiarity with EDI X12 formats and systems like CMdS, GHS, Facets.
SQL proficiency to validate data in backend tables and validating X12 files.
Understanding of Interface Testing and data flow between systems.

Benefits

Comp & perks

Health insurance coverage
Voluntary dental and vision programs
Life and disability insurance
Retirement savings plan
Paid holidays
Paid time off (PTO) or vacation and/or sick time
Career Growth Opportunities
Great Work Environment