Healthcare Business Analyst - Cerritos - Axelon Services Corporation

    Axelon Services Corporation
    Axelon Services Corporation Cerritos

    6 days ago

    Description

    Job Title: Business Analyst (Hybrid)

    Apply now, read the job details by scrolling down Double check you have the necessary skills before sending an application.
    Location: Cerritos, CA | Pay: 44.28/hr

    *Please include your Linkedin on your resume*

    Job Description:

    The ideal candidate will possess strong analytical capabilities, hands-on experience with the Availity portal and clearinghouse integrations, and the ability to collaborate effectively with business, operations, and technical stakeholders across distributed teams.

    Responsibilities:

    • Conduct end-to-end analysis of payer and provider workflows involving Availity transactions, including Eligibility & Benefits (270/271), Claims Status (276/277), Prior Authorization (278), Attachments, and Claims (837/835).
    • Evaluate business requirements, integration patterns, and data flows to ensure alignment with Availity capabilities and enterprise operational needs.
    • Review Availity response data, error codes, payer-specific rules, and transaction exceptions for accuracy, completeness, and compliance with EDI standards.
    • Support implementation, enhancement, and optimization of Availity portal features, API integrations, and clearinghouse configurations.
    • Lead requirement-gathering sessions with operations, product teams, and technical stakeholders; document functional requirements, user stories, acceptance criteria, and workflow diagrams.
    • Assess the business impact of Availity-related changes, EDI mapping updates, and upstream/downstream process modifications.
    • Perform root cause analysis for transaction failures, rejections, eligibility discrepancies, and authorization processing issues.
    • Develop test plans, execute UAT, and validate end-to-end transaction integrity for Availity workflow enhancements.
    • Prepare documentation, reports, analysis logs, and communication materials for both technical and non-technical audiences.
    • Conduct research and evaluate clearinghouse rules, EDI compliance requirements, and payer implementation guides.
    • Provide SME-level guidance to project teams and serve as a resource for Availity operations, payerprovider transactions, and healthcare EDI standards.

    Qualifications:

    • Bachelors degree in Healthcare Administration, Information Systems, Business, or a related field.
    • Minimum 5 years of experience as a Healthcare Business Analyst within a payer or provider environment.
    • Hands-on experience with Availity Portal, Availity APIs, or clearinghouse integrations required.
    • Strong understanding of HIPAA-standard EDI transactions (270/271, 276/277, 278, 837, 835) and healthcare administrative processes.
    • Experience documenting business requirements, process flows, and business rules related to eligibility, claims, and authorizations.
    • Knowledge of healthcare data protection requirements and payer/provider transaction guidelines.
    • Experience supporting business operations, compliance reviews, or audit activities in a healthcare environment.
    • Ability to analyze transaction data, troubleshoot integration issues, and interpret Availity error responses and payer communications.
    • Excellent written and verbal communication skills with the ability to create clear documentation and present findings effectively.
    • Comfort working with cross-functional, U.S.-based teams and engaging directly with business stakeholders. xhuatnn
    • Proficiency with MS Word, MS Excel, JIRA, Confluence, and standard EDI/Availity reporting tools.

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