Claims Business Analyst
Pride Health, New York, NY, United States
Contract:
Approx. 8 weeks (with potential extension)
Schedule:
Monday–Friday | 9:00 AM – 5:00 PM (Hybrid)
Pay:
Up to $60/hour
Job Summary
Pride Health is seeking an experienced
Lead Claims Business Analyst
for a contract opportunity in New York, NY. This role will serve as the primary point of contact for the Claims Processing workstream, supporting system implementation, workflow optimization, and process improvement initiatives within a healthcare environment.
Responsibilities
Serve as the main point of contact for the Claims Processing workstream
Gather, analyze, and document business requirements in collaboration with stakeholders and consultants
Develop current and future state workflows for claims processes and downstream systems
Identify gaps in processes and documentation; recommend and implement improvements
Partner with leadership to define product roadmaps and prioritize system enhancements
Review and validate business requirements, workflows, policies, and procedures
Collaborate with QA teams to define test cases, scenarios, and acceptance criteria
Support UAT testing and ensure alignment with business requirements
Identify and resolve system or process deviations during testing phases
Assist in development and review of training materials
Monitor project progress and provide updates to stakeholders
Act as liaison between business, technical teams, and leadership
Ensure timely delivery of project milestones and objectives
Requirements
Strong experience as a Business Analyst in healthcare or claims environment
Hands-on experience with claims processing (Medicaid/Medicare/Commercial)
Proven experience with UAT, test case creation, and system implementation
Strong analytical, problem-solving, and process improvement skills
Experience with workflow documentation and gap analysis
Excellent communication and stakeholder management skills
Preferred Qualifications
Experience with Behavioral Health claims
Prior experience working on large-scale system implementations
Strong understanding of healthcare operations and claims lifecycle
Ability to work cross-functionally with technical and business teams
Why Work with Pride Health?
Pride Health offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k) retirement savings, life & disability insurance, an employee assistance program, legal support, auto and home insurance, pet insurance, and employee discounts with preferred vendors.
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Approx. 8 weeks (with potential extension)
Schedule:
Monday–Friday | 9:00 AM – 5:00 PM (Hybrid)
Pay:
Up to $60/hour
Job Summary
Pride Health is seeking an experienced
Lead Claims Business Analyst
for a contract opportunity in New York, NY. This role will serve as the primary point of contact for the Claims Processing workstream, supporting system implementation, workflow optimization, and process improvement initiatives within a healthcare environment.
Responsibilities
Serve as the main point of contact for the Claims Processing workstream
Gather, analyze, and document business requirements in collaboration with stakeholders and consultants
Develop current and future state workflows for claims processes and downstream systems
Identify gaps in processes and documentation; recommend and implement improvements
Partner with leadership to define product roadmaps and prioritize system enhancements
Review and validate business requirements, workflows, policies, and procedures
Collaborate with QA teams to define test cases, scenarios, and acceptance criteria
Support UAT testing and ensure alignment with business requirements
Identify and resolve system or process deviations during testing phases
Assist in development and review of training materials
Monitor project progress and provide updates to stakeholders
Act as liaison between business, technical teams, and leadership
Ensure timely delivery of project milestones and objectives
Requirements
Strong experience as a Business Analyst in healthcare or claims environment
Hands-on experience with claims processing (Medicaid/Medicare/Commercial)
Proven experience with UAT, test case creation, and system implementation
Strong analytical, problem-solving, and process improvement skills
Experience with workflow documentation and gap analysis
Excellent communication and stakeholder management skills
Preferred Qualifications
Experience with Behavioral Health claims
Prior experience working on large-scale system implementations
Strong understanding of healthcare operations and claims lifecycle
Ability to work cross-functionally with technical and business teams
Why Work with Pride Health?
Pride Health offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k) retirement savings, life & disability insurance, an employee assistance program, legal support, auto and home insurance, pet insurance, and employee discounts with preferred vendors.
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