Senior Business Systems Analysis Professional
SS&C Technologies
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteSalary
💰 $85,000 - $100,000 per year
Job Level
Senior
About the role
- Take ownership of critical processes to ensure accuracy and compliance for pharmacy point-of-sale Coordination of Benefits (COB) adjudicated claims.
- Analyze complex issues, evaluate multiple variables, and contribute to shaping departmental strategy.
- Serve as a subject matter expert for pharmacy COB processes and claims processing logic.
- Analyze, monitor, and enhance processes and adjudication logic for pharmacy COB point-of-sale claims.
- Lead projects related to process or logic changes across internal and external areas.
- Create, update, and maintain reports, policies, and procedure documents.
- Maintain compliance with all federal and state requirements.
- Participate in CMS program audits and internal mock audits.
- Collaborate with internal and external partners on cross-functional project teams to identify impacts, define requirements, and conduct end-to-end testing.
- Act as the subject matter expert for User Acceptance Testing (UAT) in COB claims processing, checking that systems work correctly and deliver quality results.
Requirements
- Proven experience with Coordination of Benefits (COB) processes and pharmacy claims adjudication.
- Familiarity with CMS Prescription Drug Manuals used for COB Claims Processing, and ability to interpret and apply federal and state requirements.
- 3–5 years of experience in data analysis and problem-solving for process and workflow optimization.
- Proficiency in Microsoft Office applications (Access, Word, Excel, PowerPoint).
Benefits
- health
- dental
- 401k plan
- tuition and professional development reimbursement plan
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
data analysisproblem-solvingprocess optimizationworkflow optimizationclaims processingadjudication logicUser Acceptance Testing (UAT)report creationpolicy documentationprocedure documentation
Soft skills
ownershipcollaborationcommunicationleadershipstrategic thinking