Note: The job is a remote job and is open to candidates in USA. Enlyte is a company that combines innovative technology, clinical expertise, and human compassion to support individuals recovering from workplace injuries or auto accidents. They are seeking a Senior Business Systems Analyst to analyze complex business problems, lead product initiatives, and collaborate with internal teams to enhance their medical billing software for Workers' Compensation and Auto lines of business.
Responsibilities
- Lead comprehensive requirements analysis for Workers' Compensation and Auto medical bill review workflows, complex fee schedule configurations, and multi-state regulatory compliance across both lines of business
- Design and document advanced solution specifications for data integration processes including inbound and outbound data feeds, file-based exchanges, and real-time system-to-system connectivity
- Architect and validate sophisticated business requirements for real-time medical provider data exchange, eligibility verification systems, and claims processing workflows across Workers' Compensation and Auto medical billing
- Lead requirements gathering initiatives for structured file processing (CSV, XML, JSON, flat file), data transformation specifications, and end-to-end transaction processing across multiple trading partners
- Develop innovative documentation standards and methodologies for medical billing validation, complex CPT/ICD coding scenarios, system integration specifications, and regulatory compliance requirements
Skills
- Bachelor's degree in computer science or related field
- Minimum 5+ years of business systems analysis experience with demonstrated expertise in healthcare, medical billing, Workers' Compensation, or Auto insurance systems
- Ability to translate business requirements to pseudo-technical specifications
- Expert-level experience in agile/scrum environments as a product owner or senior BA, with proven ability to own and prioritize product backlogs, lead sprint planning, and guide development teams
- Strong proficiency in writing SQL queries (queries, stored procedures, selects, updates, SSIS) for data analysis, requirements validation, and system investigation across relational databases
- Demonstrated ability to create comprehensive technical specifications, process flows, data mapping documents, and integration requirements using tools such as Jira, Azure DevOps, or Confluence
- Deep understanding of data integration patterns, structured file processing (CSV, XML, JSON, flat file), data transformation requirements, and compliance validation across multiple trading partners
- Strong understanding of medical billing processes, CPT/ICD/HCPCS coding complexities, and casualty insurance medical management across Workers' Compensation and Auto lines of business
- Property and Casualty or Healthcare industry knowledge highly preferred
Benefits
- Medical
- Dental
- Vision
- Health Savings Accounts / Flexible Spending Accounts
- Life and AD&D Insurance
- 401(k)
- Tuition Reimbursement
- An array of resources that encourage a lifetime of healthier living
Company Overview
Enlyte is an information service company that provides case management, clinical software, and auto-physical damage solutions. It was founded in 1946, and is headquartered in San Diego, California, USA, with a workforce of 5001-10000 employees. Its website is https://www.enlyte.com/.