Pega Systems Analyst

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 #J-18808-Ljbffr Veriipro