Senior Business Systems Analyst – Provider Network Pricing

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Senior Business Systems Analyst leveraging expertise in claims and provider pricing at Blue Cross NC. Optimizing systems and processes while collaborating with IT and business teams to drive impactful solutions.

Posted 5/20/2026full-timeDurham • Kentucky, Louisiana, Mississippi, South Carolina • 🇺🇸 United StatesSenior💰 $89,174 - $142,679 per yearWebsite

About the role

Key responsibilities & impact

Provide Network Pricing knowledge and support in system/application and procedural issues to the business and IT.
Use judgment and initiative to review, analyze and develop solutions and applicable business processes for business systems.
Provide systems (Facets, NetworX, Optum) analysis expertise and regularly consider the business implications of the application of technology to the current business environment.
Coordinate ongoing user support for ad hoc questions, inquiries, and service requests.
Ensure efficiency of reporting and data tools for supported business area use and for trend analysis.
Coordinate the development of system support processes with IT.
Work collaboratively on projects and initiatives with the business and IT to test and implement long-term solutions.
Act as Business Lead/Coordinator on large, complex departmental and/or some corporate projects/initiatives.
Serve as point of contact for business testing activities.

Requirements

What you’ll need

Bachelor's degree or advanced degree (where required)
5+ years of experience in related field.
In lieu of degree, 7+ years of experience in related field.
Intermediate expertise with Facets, NetworX, and Optum.
Strong PC skills with intermediate expertise with Microsoft Excel.
Intermediate CMS (Medicare) guidelines and rules knowledge.
Understanding of provider contractual terms regarding pricing.
Understanding of UB04 and HCFA1500 billing practices.
Strong interpersonal skills.

Benefits

Comp & perks

Medical, dental, and vision coverage along with numerous health and wellness programs.
Parental leave and support plus adoption and surrogacy assistance.
Career development programs and tuition reimbursement for continued education.
401k match including an annual company contribution.

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

network pricingsystems analysisbusiness process developmentreporting efficiencydata toolsbusiness testingCMS guidelinesbilling practicesprovider contractual terms

Soft Skills

judgmentinitiativecollaborationinterpersonal skills

Certifications

Bachelor's degreeadvanced degree