Lead Business Analyst

Innova Solutions is immediately hiring a
Lead Business Analyst

Position type: Permanent
Duration: Fulltime
Location: New Jersey, US

As a Lead Business Analyst, you will:

• Analyze and document the various Hold/Pend codes used in healthcare claims across payers and lines of business (commercial, Medicare, Medicaid).
• Identify root causes for claim holds and assess the automation feasibility for each scenario.
• Collaborate with clinical, operations, and compliance teams to define resolution logic for common Pend reasons (e.g., missing documentation, eligibility issues, coding errors).
• Work closely with AI engineers and architects to define functional requirements for Agentic AI agents, including task decomposition, data access needs, and decision paths.
• Document end-to-end workflows, including triggers, data inputs, agent actions, system integrations, and escalation logic.
• Facilitate and lead workshops with cross-functional stakeholders to capture pain points and co-design intelligent automation pathways.
• Define and maintain acceptance criteria, use cases, and test scenarios for agent-driven automation of Pend code resolution.
• Collaborate with Product Managers to build backlogs and roadmaps for AI-driven claims process automation.
• Ensure business requirements align with payer policy, CMS guidelines, and HIPAA compliance

Candidate must have skills:

• 5+ years of experience as a Business Analyst or Product Owner in healthcare claims, payer operations, or revenue cycle
• management.
• Deep understanding of claims adjudication workflows and Pend/Hold code classification.
• Experience documenting business process automation (BPA) or intelligent automation (IA) solutions.
• Familiarity with Agentic AI concepts, LLMs, and AI-enabled decision systems (training will be provided if needed).
• Proficiency in creating BRDs, FRDs, process maps, user stories, and traceability matrices.
• Strong stakeholder management, cross-functional facilitation, and communication skills.

Required Skills:

• Experience with Google Cloud Vertex AI, Dialogflow, or other LLM platforms.
• Familiarity with healthcare data standards like FHIR, X12 (837/835), ICD/CPT/HCPCS codes.
• Exposure to RPA, low-code/no-code tools, or AI agent orchestration platforms.
• Understanding of medical necessity, pre-authorization, or coding validation workflows.

Qualified candidates should APPLY NOW for immediate consideration! Please hit APPLY to provide the required information, and we will be back in touch as soon as possible.
We are currently interviewing to fill this and other similar positions. If this role is not a fit for you, we do offer a referral bonus program for referrals that we successfully place with our clients, subject to program guidelines.
ASK ME HOW.
Thank you!

Kiran Vajrala
Manager

PAY RANGE AND BENEFITS :
Pay Range: $ 101,500 - 119,000 $ Per Year
Pay range offered to a successful candidate will be based on several factors, including the candidate's education, work experience, work location, specific job duties, certifications, etc.

Benefits:
Innova Solutions offers benefits( based on eligibility) that include the following: Medical & pharmacy coverage, Dental/vision insurance, 401(k), Health saving account (HSA) and Flexible spending account (FSA), Life Insurance, Pet Insurance, Short term and Long term Disability, Accident & Critical illness coverage, Pre-paid legal & ID theft protection, Sick time, and other types of paid leaves (as required by law), Employee Assistance Program (EAP).

ABOUT INNOVA SOLUTIONS:
Founded in 1998 and headquartered in Atlanta, Georgia, Innova Solutions employs approximately 50,000 professionals worldwide and reports an annual revenue approaching $3 Billion. Through our global delivery centers across North America, Asia, and Europe, we deliver strategic technology and business transformation solutions to our clients, enabling them to operate as leaders within their fields.

Recent Recognitions:

• Named One of America's Best Employers for New Grads by Forbes (2024
• Named One of the Best Companies to Work For by U.S. News & World Report (Private Companies List, 2024-2025)
• One of the Largest IT Staffing Firms in the US - Ranked #3 by Staffing Industry Analysts (SIA, 2024)
• One of the Largest Staffing Firms in the US - Ranked #13 by Staffing Industry Analysts (SIA, 2024; includes Innova Solutions, Volt, & HireGenics)
• Named One of the Top Ten Private Companies in Atlanta by the Atlanta Business Chronicle (2023)
• One of the Largest Certified Minority Business Enterprises (MBEs) in the United States (NMSDC, 2024)
• AWS Advanced Tier Services Partner with 100+ certifications

Website:

Innova Solutions is an Equal Opportunity Employer and prohibits any kind of unlawful discrimination and harassment. Innova Solutions is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment on the basis of race, color, religion or belief, national origin, citizenship, social or ethnic origin, sex, age, physical or mental disability, veteran status, marital status, domestic partner status, sexual orientation, or any other status protected by the statutes, rules, and regulations in the locations where it operates. If you are an individual with a disability and need a reasonable accommodation to assist with your job search or application for employment, please contact us at View email address on click.appcast.io View phone number on click.appcast.io. Please indicate the specifics of the assistance needed. Innova Solutions encourages all interested and qualified candidates to apply for employment opportunities. Innova Solutions (HireGenics/Volt) does not discriminate against applicants based on citizenship status, immigration status, or national origin, in accordance with 8 U.S.C. § 1324b. The company will consider for employment qualified applicants with arrest and conviction records in a manner that complies with the San Francisco Fair Chance Ordinance, the Los Angeles Fair Chance Initiative for Hiring Ordinance, and other applicable laws.

Thank You!
Team Innova Solutions