Senior Business Analyst – Pharmacy (RCM, Billing & Financial Reconciliation)
Core
Senior Business Analyst specializing in Specialty/Infusion Pharmacy Revenue Cycle Management (RCM), leading enterprise SaaS implementations for medical billing, claims adjudication, and financial reconciliation.
Role type
Senior IC Business Analyst (Healthcare RCM)
Builds
Enterprise SaaS implementations for pharmacy billing and revenue cycle platforms
Domain
Healthcare / Specialty Pharmacy / Revenue Cycle Management
Deliverable
production ML models | product features | dashboards & analysis | client delivery
Required skills
Business Analysis, Requirements Elicitation, Process Workflow Design, Medical Billing, Claims Lifecycle Management, Financial Reconciliation, HIPAA Compliance, SQL, Agile/Scrum, UAT Strategy, Stakeholder Management
Preferred skills
Specialty or Infusion Pharmacy domain experience, SaaS implementation experience
Technologies
Visio, SQL, Crystal Reports, APIs, FHIR, HL7, NCPDP, 837, 835
Responsibilities
Lead complex enterprise-wide RCM implementations, define governance standards and implementation plans, serve as SME for medical/pharmacy billing and claims lifecycle, optimize workflows to improve clean claim rates and reduce denial management, translate client needs into system requirements, lead User Acceptance Testing (UAT) and system validation, mentor junior analysts and promote BA best practices
Seniority
Senior, hands-on IC with mentorship responsibilities