Sr Application Analyst, Claims Systems

Job description

Anticipated End Date: 2026-09-12 Position Title: Sr Application Analyst, Claims Systems Job Description: JR205511 Sr Application Analyst, Claims Systems CareBridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. CareBridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through home-care and community based services. CareBridge is seeking a Sr Application Analyst, Claims Systems professional, to support reporting, analytics, and process improvements across the claims lifecycle. In this role, you'll use your provider-side claims, EHR/revenue cycle, and SQL/data expertise to turn complex data into actionable insights, support claim corrections, troubleshoot claims workflows, and improve processes. You’ll build reporting solutions, enhance submission performance, and partner with Product, Engineering, Finance, and Operations to improve and scale end-to-end claims processes. Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.How you will make an impact: Claims & Encounter Reporting • Build and maintain reporting to track the full claims lifecycle from submission to payer response. • Create self-service tools for Operations, Finance, and Client Success. • Reconcile data across systems to ensure accurate claim status tracking. Claims Subject Matter Expertise • Act as an SME on claims structure, clearinghouse workflows, and payer responses. • Support complex claim issues and partner with Product and Engineering to resolve data/workflow gaps and validate fixes. Payer Configuration & Onboarding • Support new payer implementations, including workflow setup and validation. • Develop standardized monitoring for go-lives and streamline payer-specific processes. Process Improvement & Operations • Identify and resolve recurring submission issues. • Partner cross-functionally to improve workflows, tools, and documentation. • Support audits and quality reviews. Minimum Requirements: • Requires an BA/BS degree in Information Technology, Computer Science or related field of study and a minimum of 6 years systems analyst or business analyst experience; or any combination of education and experience, which would provide an equivalent background. Preferred Skills, Capabilities and Experiences: • 5+ years of experience in provider-side claims, revenue cycle, or data management. • 2+ years of experience working with EHR systems, revenue cycle, and billing platforms, with provider-side claims experience strongly preferred. • Strong understanding of professional claim formats (837P), remittance advice (835), and clearinghouse workflows. • Advanced SQL skills with experience querying complex healthcare production or analytics databases. • Hands-on experience within a claims platform, including claim correction, resubmission, and configuration validation. • Experience developing reports and dashboards using BI tools (e.g., Tableau, Power BI, Metabase) • Ability to translate complex data into clear, actionable insights for business stakeholders. • Strong cross-functional communication skills with experience partnering across Product, Engineering, Finance, and Operations. • Experience working in value-based care environments. • Candidates from all states are welcome. Job Level: Non-Management Exempt Workshift: Job Family: IFT > IT Bus Systems Solutions Planning Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Heal