TekWissen LLC logo

Pega Healthcare Claims System Analyst

TekWissen LLC
  • NULL, VA
  • Remote
  • $52.14
  • Instant Apply
1 day ago

Job Description

Overview:
TekWissen is a global workforce management provider headquartered in Ann Arbor, Michigan that offers strategic talent solutions to our clients world-wide. Our client is an American multinational information technology services and consulting company and is a leading provider of information technology, consulting, and business process outsourcing services, dedicated helping the world's leading companies build stronger businesses.
Job Title: Pega Healthcare Claims System Analyst
Location: Remote
Duration: 6 Months
Job Type: Temporary Assignment
Work Type: Remote
Job Description:
  • Gather, analyze, and document business and system requirements for healthcare claims processing initiatives.
  • Work closely with business stakeholders, product owners, developers, and QA teams to ensure requirements are accurately defined and implemented.
  • Analyze healthcare claims workflows including claims intake, adjudication, adjustments, provider reimbursement, and payment processing.
  • Work with Facets modules including Claims, Membership, Billing, and Provider to support end-to-end claims lifecycle management.
  • Translate business requirements into functional specifications, user stories, process flows, and acceptance criteria.
  • Analyze member, provider, claims, benefits, and authorization data to support operational and system enhancement initiatives.
  • Support Agile development activities including backlog grooming, sprint planning, testing, defect triage, and release activities.
  • Participate in requirements workshops, stakeholder discussions, and solution design reviews.
  • Support User Acceptance Testing (UAT), validate business requirements, and assist with production issue analysis.
  • Ensure healthcare claims requirements and workflows align with HIPAA and EDI 837/835 transaction standards.
Years of Experience:
  • 8+ Years of Experience
Required Skills:
  • Healthcare Claims Processing
  • Pega
  • Facets (Claims, Membership, Billing, Provider)
  • EDI 837/835
  • Business Analysis
TekWissen Group is an equal opportunity employer supporting workforce diversity.

Numbers & Facts

LocationNULL, VA (
Remote
)
IndustryComputer/IT Services
Salary$52.14
Company Size100 to 499 employees
Year Founded2009
Websitehttp://www.tekwissen.com/

About Company

WE THE TEKWISSEN PEOPLE

TekWissen offers you a broader portfolio of services, industry-leading solutions, and the meaningful innovations that give you greater flexibility and speed to respond to market dynamics, reduced costs and risk to improve enterprise performance, and increased productivity to enable growth.

To keep pace with global market demands, TekWissen keeps its finger on the pulse of change. Our organized approach to guiding a project from its inception to closure. Managing projects is becoming more and more important as we enter the digital era. To cope with the pace that this transition demands, a method is required to manage projects so they can yield quality work, while incorporating efficient use of time and resources.

Project involves identifying which quality standards are relevant to the project and determining how to satisfy them.

It is important to perform quality planning during the Planning Process and should be done alongside the other project planning processes because changes in the quality will likely require changes in the other planning processes, or the desired product quality may require a detailed risk analysis of an identified problem. It is important to remember that quality should be planned, designed, then built in, not added on after the fact.

Capabilities and accomplishments in one TekWissen business enhance the opportunity for success in the others. Put simply, TekWissen's unique combination of attributes promotes success.



Skills

  • Acceptance Testingunmatched
  • Adjudicationunmatched
  • Agile Programming Methodologiesunmatched
  • Analysis Skillsunmatched
  • Backlog Prioritizationunmatched
  • Billingunmatched
  • Bug Tracking/Defect Managementunmatched
  • Business Analysisunmatched
  • Business Process Outsourcingunmatched
  • Business Servicesunmatched
  • Business Solutionsunmatched
  • Claims Managementunmatched
  • Claims Processingunmatched
  • Consultingunmatched
  • Diversityunmatched
  • Electronic Data Interchange (EDI)unmatched
  • HIPAA (Health Insurance Portability and Accountability Act)unmatched
  • Healthcareunmatched
  • Information Technology & Information Systemsunmatched
  • Information Technology Consultingunmatched
  • Operational Supportunmatched
  • Payment Processingunmatched
  • Problem Solving Skillsunmatched
  • Process Flowunmatched
  • Quality Assuranceunmatched
  • Reimbursementunmatched
  • Requirements Managementunmatched
  • Requirements Validation/Verificationunmatched
  • Sprint Planningunmatched
  • Systems Analysisunmatched
  • Workflow Analysisunmatched
  • Workforce Managementunmatched

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