Role description
Healthcare Claims Business Analyst
InfoMC, Inc.InfoMC is a fast-paced, healthcare technology company delivering integrated care management and population health solutions to health plans and provider organizations. Our person-centered, “whole-person care” and provider approach addresses the behavioral, physical, and social drivers that impact a member’s health and enhances the interaction between plan, enrollee, and provider. Our solutions are designed to help our customers improve quality, reduce costs, and optimize health outcomes for their population.
At InfoMC, we are extraordinarily proud of the company we’re building not to mention our continuous efforts to create a Best Place to Work culture. Our people are InfoMC’s biggest competitive advantage and we’ll continue to invest in our team and people-first culture.
The Healthcare Claims Business Analyst / Subject Matter Expert (BA/SME) serves as InfoMC’s primary domain authority for healthcare claims operations during new client onboarding engagements on the Incedo claims platform. This individual bridges the gap between client operational workflows and the technical capabilities of the Incedo solution, ensuring that each implementation is aligned with payer-side business requirements, regulatory obligations, and industry standards for electronic data interchange (EDI).
The BA/SME works directly with health plan and managed care organization clients to define requirements, configure workflows, validate transaction sets, and guide teams through end-to-end claims lifecycle processes—from member eligibility through remittance and adjudication. The ideal candidate brings deep payer-side experience with HIPAA-mandated EDI transactions, CMS reporting requirements, and the operational realities of claims processing within Medicare Advantage, Medicaid, and commercial health plan environments.