Business Systems Analyst - No Surprises Act

Location: Hybrid (2 consecutive days per month onsite in Newark, NJ). We will consider exceptional Remote candidates. Employment Type: Contract to Hire

Position Overview

Our client is seeking an experienced Business Systems Analyst with a strong background in the U.S. healthcare payer industry to support initiatives related to the No Surprises Act (NSA). This individual will work closely with business stakeholders, operations teams, and technology teams to analyze business processes, define requirements, and support enhancements to systems responsible for NSA compliance, claims processing, and reimbursement workflows. The ideal candidate is a highly analytical problem solver with healthcare payer experience and an understanding of claims processing. Experience supporting No Surprises Act implementations or ongoing compliance initiatives is highly preferred.

Responsibilities

• Analyze business and system requirements related to No Surprises Act (NSA) compliance and healthcare claims processing.
• Gather, document, and validate business requirements through collaboration with business users, technical teams, and stakeholders.
• Translate complex business needs into detailed functional specifications and user stories.
• Support system enhancements, testing, implementation, and post-production validation.
• Evaluate existing business processes and identify opportunities for improvement and automation.
• Work closely with software development teams to clarify requirements and support solution delivery.
• Participate in defect analysis, root cause investigations, and production support activities.
• Assist with data analysis and validation to ensure compliance with regulatory and business requirements.
• Communicate project status, risks, and recommendations to business and technical stakeholders.

Requirements

• 5+ years of experience as a Business Analyst, Systems Analyst, or Functional Analyst.
• Experience working within a U.S. healthcare payer environment.
• Strong analytical, critical thinking, and problem-solving skills.
• Experience gathering, documenting, and managing business and functional requirements.
• Understanding of healthcare claims processing and claims adjudication workflows.
• Excellent communication skills with the ability to interact effectively with both business and technical teams.
• Experience supporting software development projects utilizing Agile, Waterfall, or hybrid methodologies.

Preferred Qualifications

• Direct experience supporting No Surprises Act (NSA) implementations, enhancements, compliance initiatives, or production support.
• Knowledge of Independent Dispute Resolution (IDR) processes and NSA reimbursement requirements.
• Experience with out-of-network claims pricing and reimbursement methodologies.
• Understanding of provider reimbursement, payment integrity, or medical claims pricing.
• Previous software development or technical programming experience.
• Experience working with healthcare claims platforms or payer core administration systems.
• Experience creating SQL queries for data analysis and validation.
• Knowledge of healthcare data standards and regulatory compliance.