Business Systems Analyst

Oregon

We are seeking a **senior Business Systems Analyst** to support healthcare payor operations focused on **encounter and claims data** , with a strong emphasis on **Medicare and CMS submissions**. This role plays a critical part in ensuring data accuracy, regulatory compliance, and timely submission of encounter data across core health plan systems. This is a **fully remote position within the U.S.** , with a requirement to work **Pacific Time (PST) business hours**. Location Fully Remote (Oregon, Washington, or California strongly preferred) Schedule Monday--Friday, 8:00am--5:00pm PST Contract Duration **Initial 3--6 month contract** with a strong likelihood of extension through 2026 and potential conversion to permanent employment in 2027. What You'll Do * Analyze healthcare **encounter and claims data** to ensure completeness, accuracy, and timeliness prior to submission * Support **Medicare and Medicaid** lines of business by validating encounter data submitted to **CMS and state agencies** * Perform **root‑cause analysis** on rejected, failed, or incomplete encounters using **SQL queries** * Partner with business, operations, and technical teams to identify and resolve data and system issues * Work within core health plan systems, primarily **FACETS**, to monitor and troubleshoot data flows * Ensure compliance with regulatory and reporting requirements in a highly controlled environment Required Qualifications * 5--8 years of experience as a **Business Systems Analyst** * Recent experience in a **healthcare payor environment** * Hands‑on experience supporting **Medicare, CMS, or government program reporting** * Strong knowledge of **encounter data and claims workflows** * Advanced experience writing and analyzing **SQL queries** * Excellent communication skills and a high level of professionalism Preferred Qualifications * Experience with **FACETS** and **EDI (X12)** * Familiarity with **Informatica** and/or **Power BI** * Bachelor's degree in Business, Information Technology, or a related field * Relevant IT or healthcare certifications $40.00- $50.00 per hour Exact compensation may vary based on several factors, including skills, experience, and education. Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.