Sr. Business Analyst

Professional Services National, United States


Sr. Business Analyst


Edifecs is a leading healthcare technology company with the mission to improve healthcare outcomes, reduce costs and accelerate innovation. We lead the industry in the breadth and depth of how we support our customers—by becoming an extension of their internal team. Helping our SaaS customers deliver world-class care and service is the Managed Services Team. The Managed Services team is seeking a Sr. Business Analyst, who will operate as a spokesperson for the client’s business needs as they interact with the IS and IT groups to determine appropriate computer-related solutions to business problems.  The Business Analyst provides analysis, definition and direction to computer-related development and maintenance activities, and assists with ensuring that correct business functionality, requirements, and industry standards are addressed within the computer applications.

What you will do:

  • Understand Edifecs Encounter Management (EM) solution and encounter submission process to CMS and State Medicaid.
  • Assist customers to effectively use EM solution to meet their business requirements.
  • Conduct weekly calls with clients to review open issues and prioritize issues.
  • Perform functional analysis of issues reported by clients, gather requirements, identify gaps, and coordinate with internal teams to address the gaps.
  • Analyze CMS and State specific EDI companion guides to define data and rules requirements
  • Write custom business rules to meet client specific requirements in the solution and rules for data mapping and transformation
  • Perform analysis of customer data using information available in application and SQL queries, identify any issues, and promptly report to customers for timely resolution to achieve better acceptance rates.
  • Write proof of concept reports using a variety of reporting methods and develop sample data for use in demonstrations
  • Monitor and perform basic technical analysis of the solution to help identify any system issues and involve appropriate internal teams to resolve issues in a timely manner.


What you will bring:

  • Bachelor’s degree in a Computer Science or related field required
  • 6+ years healthcare information experience
  • 3+ years of experience with healthcare EDI formats specifically HIPAA 837 files
  • Experience working with Electronic Data Interchange (EDI) mapping, EDI analysis or healthcare transaction processing
  • Experience in creating functional specifications, technical specifications, deployment instructions, operations guides and other systems documents
  • Experience analyzing and solving business/systems problems in the healthcare or IT industry
  • Experience using software engineering tools for configuration management, defect tracking, unit testing, system testing, build and deployment
  • Experience using software life-cycle methodologies such as waterfall, agile-scrum in developing products and IT applications
  • Demonstrated knowledge of databases and data analysis and moderate level of SQL experience
  • Strong understanding of information technology
  • Project Management experience is a plus
  • In depth ability to understand EDI structures and encounter submission process is a large plus
  • Excellent verbal, written and interpersonal skills
  • Excellent attention to detail and commitment to follow through
  • Excellent organizational, prospecting and follow-up skills
  • Self-motivated, problem solving skills; must be a self-starter
  • Experience in a fast paced, start-up environment a plus

Note: The expected base pay range for this position is $87,500 - $119,000 per year. Base pay offered may vary depending on location, job-related knowledge, education, and experience. 

 We are pleased to offer our associates a comprehensive well-being plan.  Our offerings include medical, dental, vision, life, and disability insurance, a 401(k) retirement savings plan including an Edifecs matching contribution, and up to 25 days of PTO and 10 holidays per year.  More information on these and additional well-being offerings can be found here.


About Edifecs

Edifecs is a premier technology company in the U.S. Healthcare market with solutions focused on interoperability, workflows, risk adjustment, value-based care payments, and analytics. Edifecs solutions are used by leading healthcare entities including, payers, providers, employers, third party administrators, and government agencies. With innovative technology and solutions, Edifecs helps its customers by optimizing the secure exchange and processing of administrative and clinical data, reducing the cost of complying with regulations, and automating workflows involved in multiple core processes within the healthcare ecosystem.

Edifecs is a frontrunner in providing solutions for B2B data exchange, streamlining key workflows in areas such as enrollment, risk adjustment, and alternative payment models. With the advent of FHIR and new regulatory guidance from HHS, Edifecs has emerged as a leader in easing the effort associated with achieving compliance with new federal rules and in making the healthcare consumer the primary stakeholder. Edifecs solutions are offered in both On-Premise and SaaS models. The company is headquartered in Bellevue, Washington, with additional offices in Atlanta, Georgia and Mohali, India, an engineering center in Moldova, and has more than 1,000 employees.

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, religion, national origin, protected veteran status, disability status, or any other characteristic protected by law.

Edifecs will provide reasonable accommodation to individuals with disabilities who need assistance applying for a job.  Please contact [email protected] for more information.