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# Pega Healthcare Claims System Analyst

- **Company:** Ztek Consulting
- **Location:** United States
- **Contract:** Contract
- **Skills:** Agile Methodology, Software Bug Management, Scrum Methodology, Software Requirements Analysis, Pega
- **Published:** November 13, 2026
- **Apply:** https://www.dice.com/job-detail/cdabd72b-85ef-486f-a131-229deafb00a9

## About the Role

1. Healthcare Claims Processing
 2. Pega
 3. Facets (Claims, Membership, Billing, Provider)
 4. EDI 837/835
 5. Business Analysis

## Description

* Gather, analyze, and document business and system requirements for healthcare claims processing initiatives.
 * Work closely with business stakeholders, product owners, developers, and QA teams to ensure requirements are accurately defined and implemented.
 * Analyze healthcare claims workflows including claims intake, adjudication, adjustments, provider reimbursement, and payment processing.
 * Work with Facets modules including Claims, Membership, Billing, and Provider to support end-to-end claims lifecycle management.
 * Translate business requirements into functional specifications, user stories, process flows, and acceptance criteria.
 * Analyze member, provider, claims, benefits, and authorization data to support operational and system enhancement initiatives.
 * Support Agile development activities including backlog grooming, sprint planning, testing, defect triage, and release activities.
 * Participate in requirements workshops, stakeholder discussions, and solution design reviews.
 * Support User Acceptance Testing (UAT), validate business requirements, and assist with production issue analysis.
 * Ensure healthcare claims requirements and workflows align with HIPAA and EDI 837/835 transaction standards.