This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Senior Business Analyst, Medical Coding & Policy based in the United States.
As a Senior Business Analyst, Medical Coding & Policy, you will serve as a key link between healthcare operations, technical delivery teams, and client stakeholders, ensuring that medical coding, billing, and policy requirements are translated into effective system solutions. In this highly collaborative role, you will leverage your expertise in medical coding and business analysis to improve claims processing, operational workflows, and Medicaid program delivery. You will help transform complex regulatory and business requirements into clear documentation, actionable guidance, and scalable solutions that support both operational excellence and successful implementations. Working in a fully remote environment, you'll collaborate with cross-functional teams while contributing to initiatives that enhance healthcare services and improve outcomes for the communities served.
Accountabilities:
- Lead the analysis, documentation, and delivery of coding, billing, and policy-related business solutions from initial requirements through implementation and project completion.
- Gather, analyze, and document business, functional, and operational requirements while translating complex medical coding and billing concepts into clear, actionable deliverables.
- Develop and maintain claims processing instructions, operational procedures, and policy documentation using concise, user-friendly language.
- Assess the impact of coding, billing, and claims processing changes on business operations and system functionality to ensure alignment across teams.
- Act as the primary liaison between operations, business analysts, technical delivery teams, and client stakeholders to ensure consistent understanding of business requirements.
- Participate in requirements workshops, solution design sessions, operational meetings, and client presentations to support project success.
- Maintain documentation standards, coordinate project communications, track action items, and provide regular updates to project leadership and stakeholders.
- Mentor and support fellow business analysts by providing subject matter expertise in medical coding, billing, and healthcare policy.
Requirements
- Minimum of six years of experience as a Business Analyst, Medical Coding Analyst, or in a related healthcare-focused role.
- Certified Professional Coder (CPC) credential or equivalent advanced medical coding expertise is required.
- Experience supporting healthcare, Medicaid claims processing, medical coding, billing operations, or healthcare system implementations.
- Strong understanding of business analysis methodologies, requirements elicitation, software development lifecycle (SDLC), and testing alignment.
- Demonstrated ability to develop structured business requirements, claims processing documentation, operational procedures, and policy guidance.
- Solid understanding of healthcare operations, claims adjudication, coding standards, and billing workflows.
- Strong analytical, organizational, and problem-solving skills with exceptional attention to detail.
- Excellent written and verbal communication skills with the ability to collaborate effectively with technical teams, operational stakeholders, and clients.
- Ability to work independently while managing multiple priorities in a remote, collaborative environment.
Benefits
- Fully remote position available from most locations within the contiguous United States.
- Competitive annual salary ranging from $69,400 to $99,200, based on experience, location, and qualifications.
- Comprehensive health, medical, and wellness benefits.
- 401(k) plan with employer matching contributions.
- Generous and flexible paid vacation policy.
- Educational assistance and support for ongoing professional development.
- Leadership and technical development programs designed to advance your career.
- Flexible work environment with limited travel requirements (0–5%).
- Opportunity to contribute to impactful healthcare initiatives that improve public health programs.