Systems Analyst

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary Are you passionate about solving complex business problems through technology? Do you thrive at the intersection of healthcare, analytics, and systems design?

Join our Payment Integrity Product team and help drive solutions that improve claims accuracy, reduce unnecessary healthcare costs, and strengthen operational efficiency across the organization. As a Systems Analyst, you will play a key role in designing, enhancing, and supporting technology solutions that enable payment integrity initiatives, improve claims adjudication accuracy, and deliver measurable business value.

You will collaborate with Product Owners, Business Analysts, Architects, Developers, and Operations teams to translate complex business needs into scalable, high-performing technology solutions. NOTE: This is a WFH role. Sponsorship is not available including if you are currently on OPT. Required Job Qualifications Bachelor's degree in Computer Science, Information Technology, Healthcare Informatics, or a related field. Experience supporting Payment Integrity, Claims Processing, Claims Adjudication and Healthcare Payer operations.

Working knowledge of healthcare claims platforms, provider reimbursement methodologies, coding systems (ICD, CPT, HCPCS), and payment policy implementation. Experience translating business and operational requirements into detailed technical specifications, system designs, and solution documentation. Familiarity with payment integrity programs such as pre-pay and post-pay edits, clinical editing, fraud, waste and abuse detection, and reimbursement accuracy initiatives.

Experience working with large healthcare data sets and analytics platforms to identify trends, measure savings, and support payment accuracy initiatives. Knowledge of cloud-based technologies, SaaS platforms, APIs, REST services, and system integration patterns. Experience supporting Agile delivery teams and collaborating with Product Owners, Business Analysts, Architects, and Operations teams throughout SDLC. Strong analytical and problem-solving skills with the ability to assess complex business issues and recommend effective technology solutions.

Ability to manage production support activities, troubleshoot application issues, and drive resolution of operational incidents impacting claims processing and payment integrity outcomes. Experience with SQL, data analysis, reporting, and healthcare data warehouses preferred. Excellent written and verbal communication skills with the ability to influence stakeholders across business and technology organizations. Knowledge of healthcare payer operations and Blue Cross Blue Shield business processes is highly desirable.

Preferred Job Qualifications: Critical thinker who enjoys solving complex business and technical challenges. Can effectively bridge the gap between business needs and technical solutions. Comfortable navigating ambiguity and driving outcomes in a fast-paced environment. Have a passion for leveraging technology to improve healthcare payment accuracy and affordability. Thrive in highly collaborative environments and excel at building strong partnerships across teams.

This is an opportunity to work on high-visibility initiatives that directly impact healthcare affordability, claim accuracy, and member experience. You'll be part of a collaborative product organization focused on innovation, continuous improvement, and delivering meaningful outcomes for our customers, providers, and members. If you're looking to make a measurable impact while advancing your career in healthcare technology and payment integrity, we'd love to hear from you. #LI-BS1 #LI-Remote Are you being referred to one of our roles?

If so, ask your connection at HCSC about our Employee Referral process! Pay Transparency Statement: At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees.

Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards. The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. This position may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii.

HCSC Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. We are a drug-free and smoke-free workplace.

Employment may be contingent upon successful completion of drug screening in accordance with applicable law. Base Pay Range $69,800.00 - $125,900.00 Exact compensation may vary based on skills, experience, and location. Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities. Join our Talent Community.

For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities.

Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren’t afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you’ll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants.

If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations. Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions.

Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.

• Bachelor's degree in Computer Science, IT, Healthcare Informatics, or related field with experience in Payment Integrity and Claims Processing.
• Knowledge of healthcare claims platforms, coding systems (ICD, CPT, HCPCS), payment policies, and payment integrity programs.
• Experience translating business needs into technical specifications, supporting Agile teams, and managing production support with strong analytical skills.