Pega Systems Analyst
2T Consulting
Role Overview
We are seeking a Pega Systems Analyst with strong healthcare insurance experience to support initiatives focused on claims intake, pre-adjudication validation, and workflow/UI enhancements. The role acts as a liaison between business and IT, translating business needs into functional and technical requirements while ensuring alignment with system capabilities and performance expectations.
Roles and Responsibilities
- Lead requirements gathering sessions with business and technical stakeholders
- Define functional, usability, performance, and support requirements
- Support system design, testing, and implementation activities
- Develop use cases, process flows, and functional documentation using standard tools
- Identify opportunities for process improvement, automation, and workflow optimization
- Support dashboarding and reporting enhancements for claims operations
- Collaborate on inbound claims processing workflows and validation processes
Required Skills & Experience
- Strong experience with Pega platform and healthcare claims systems
- Experience in claims operations, including intake, validation, and pre-adjudication processes
- Familiarity with claims intake platforms (e.g., portal-based intake, EDI/clearinghouse workflows such as Edifecs or similar)
- Experience in healthcare payer or insurance environments
- Strong SQL skills for data analysis and validation
- Ability to translate business requirements into technical specifications
- Excellent communication and stakeholder management skills
Preferred Skills
- Experience supporting workflow/UI enhancements within Pega applications
- Knowledge of claims balancing and adjudication lifecycle processes
- Experience with reporting tools and dashboard development
- Exposure to automation initiatives in claims processing environments
Vacancy posted 3 days ago
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