Claims Business Analyst

Position: Lead Claims Business Analyst

Location: New York, NY 10004

Job Type: Contract

Contract: Approx. 8 weeks (with potential extension)

Schedule: Monday–Friday | 9:00 AM – 5:00 PM (Hybrid)

Guaranteed hours per week: 35.00

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.