Business Analyst Healthcare Claim Resume Examples + Tips

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You’re a business analyst trained to work in the healthcare industry. You have specialized in the field, but you are looking for a job with a focus on healthcare claims. 

You might have some experience or you might be punting for an entry-level job after graduating from university. Either way, you’re going to need a good, solid resume to help make your resume stand out from those submitted by other applicants. 

We’ve got tips and advice and a complete resume sample that will help you. 

Resume objective for business analyst healthcare claim jobs

Healthcare business analysts are commonly employed by corporate medical billing facilities or healthcare organizations. 

While they have business and information management skills, many organizations employ them to work in particular departments, for instance, to evaluate and analyze claims. 

In this context, claims are requests for payment that patients or healthcare providers submit to health insurers. It is the healthcare business analyst’s job to pinpoint problems or identify areas of improvement regarding claims. 

When you write your resume, you will need to show that you have the skills and abilities needed to do this. 

Resume objective statements are often included at the top of the document. While optional, a resume objective can be a very useful tool if you use it to highlight the value you will provide to the job.

According to the American College for Medical Careers (ACMC), a private college that provides healthcare career education, an objective statement is helpful but optional.

If you do include one, make sure that it sums up your immediate career goals.

Sample Objective

Healthcare business analyst with two years of experience, ready for increased responsibilities in a medical environment. Excels at evaluating healthcare claims and recommending solutions. Keen to develop project management skills. 

Resume skills for business analyst healthcare claim jobs

Healthcare business analysts rely on critical thinking skills and financial management expertise to do their jobs. 

Other skills will depend largely on the employer’s needs and level of the position. For instance, entry-level healthcare business analyst jobs usually entail tasks that relate to one specific area of medical operations. More senior positions require years of varied experience in the field. 

When you list your skills on a business analyst healthcare claims resume, consider the skills you learned during training as well as skills you have developed at work. 

They may be patient/clinical skills, office/admin skills, customer service skills, and without a doubt, analytical business skills. 

Then consider the job description carefully, and see how your skills and the skills required for the job compare. You want them to match as closely as possible. 

We sampled scores of job posts to get a good idea of the skills employers find valuable. Those listed below are general and don’t relate to any particular position or seniority. 

Sample Skills

Oral and written communication | Critical thinking | Problem-solving | Attention to detail | Motivated | Appreciation of quality work | Data interpretation | Microsoft Excel | Computer software | Independent worker | Self-starter

Business analyst healthcare claim work experience

Work experience is always an important part of any resume. Always start your list with the newest, most relevant position first. Include details of what you did, but also showcase your key achievements. 

If you can include statistics, do so. Numbers always look good in a resume. For example, how many claims did you process in a day or a week? How accurate was your work?

If you are a new graduate and you are applying for an entry-level job that doesn’t require prior experience, you should still try to supply examples – if you can! 

If you have worked as an intern or as an extern, add this. Even if the position was only for a few weeks and was unpaid, it will count as a real-life experience. Be sure to highlight what you did and what you learned during this time. 

Don’t be tempted to add irrelevant work experience. Stick to business analyst and healthcare jobs. 

Sample Work Experience

Berkley, NJ

Claims Analyst, 2018 – 2020

Reviewed and evaluated all captive stop-loss claim submissions received and logged in the company’s claim system. Determined whether the amounts requested were eligible for reimbursement under the company’s stop-loss policy. 

  • Processed up to seven claims a day. 
  • Maintained processing accuracy of 99.5%.
  • Determined the eligibility of assigned claims by applying the appropriate  

Centene Corporation, CA

Business Analyst I (Healthcare Claims), 2017 – 2018

Worked as a Healthcare Business Analyst in the company’s claims department. This was an entry-level position that didn’t require prior experience.

  • Performed various analyses and interpreted these to link business needs and objectives for specifically assigned functions.
  • Supported business initiatives through data analysis, and identified implementation barriers.
  • Undertook user-acceptance testing of three new systems.
  • Identified and analyzed user requirements, procedures, and problems to improve existing processes. Received several commendations. 
  • Performed detailed analysis on assigned projects, recommended potential business solutions, and assisted with the implementation of these.

Milliman, IN

Healthcare Business Analyst Intern, 2016

Responsible for developing and executing solutions based on research and data-driven analyses. These were all in support of payer marketing strategies, including claims, as well as collateral for pipeline and in-market assets. 

  • Performed secondary research relating to healthcare claims and summarized findings.
  • Contributing to the development of five marketing campaigns. This included writing copy and coordinating resources necessary to finalize collateral.
  • Developed and implemented data-driven analysis plans to address project objectives.
  • Developed visually appealing client presentations with direction from more senior team members.
  • Met with senior team members more than once a week to gain a clear understanding of project goals, expectations, and activities. 

Business analyst healthcare claim education

When we sampled job posts we found that the norm for business analysts seeking employment in the healthcare industry is a bachelor’s degree from an accredited institution. Most employers specify a specialization, usually finance, accounting, or healthcare administration. 

According to the University of Nevada, Reno, most healthcare business analyst jobs call more specifically for a bachelor’s degree in healthcare management or business administration. 

They recommend that students who are aiming for higher-level roles that involve big data analysis get a Master of Science in Business Analytics. This is based on feedback from the International Institute of Business analytics that highlights the current rapid expansion of healthcare technologies. 

Universities commonly expect master’s applicants to have a bachelor’s degree from an accredited university as well as at least three years of professional work experience. 

The University also highlights a potential issue they commonly identify in the healthcare analytics field. They state that students who focus on business analytics sometimes struggle to get real-life experience in healthcare settings. 

The problem is that even if they have stand-out skills and abilities in effective budgeting, operations management, financial statements, and claims experience, they may miss the opportunity when employers prioritize healthcare experience. 

Taking healthcare-related courses alongside financial and business courses will bridge this gap.

As mentioned above, internships also offer the opportunity to work at medical and healthcare facilities, in this way providing valuable experience.

Sample Education

The George Washington University School of Business

Healthcare MBA, 2017

University of Nevada, Reno

Bachelor’s Degree in Healthcare Management, 2013 – 2016

Courses 

If you opt for certification through the Canadian-based International Institute of Business Analysis (IIBA), you will need to earn at least 60 continuing development units (CDUs) every three years to be able to recertify. 

The education and training required is endorsed by the IIBA. There is a full list of courses on their website as well as information about education providers. 

There is nothing to stop you from taking one or more of these courses even if you aren’t planning to become certified.

Since some healthcare business analyst jobs (including the one we have based our sample resume on) require coding experience, you might want to take coding courses.

The American Academy of Professional Coders (AAPC) offers medical coding courses that are designed by healthcare professionals. Many of them teach the fundamentals of medical coding and show students how to work with real medical cases and charts. 

Sample Courses

  • Business Analysis Essentials
  • Advanced Business Analysis
  • Agile Business Analysis
  • Applied Data Analysis Workshop
  • Business Analysis Practices
  • Certified Business Analysis Professional
  • Consulting Skills for the Business Analyst
  • Coding for Hospital Applications/Hospital Medical Billing
  • Coding for Medical Office Applications/Physician Medical Billing

Certifications

Healthcare business analysts are not expected to be certified. However, there are voluntary certifications that will increase your knowledge and credibility.

The IIBA offers several core business analysis certifications. These include:

  • Entry Certificate in Business Analysis (ECBA), the only IIBA certification that doesn’t require recertification. 
  • Certification of Capability in Business Analysis (CCBA)
  • Certified Business Analysis Professional (CBAP) 

The Project Management Institute (PMI) also offers Professional in Business Analysis (PMI-PBA) certification.

The PMI-PBA highlights the expertise of business analysts. It spotlights an ability to work effectively with stakeholders to define their business requirements, shape the output of projects, and drive successful business outcomes.

It’s available online. 

None of these business analyst certifications focus on healthcare. But they are all still relevant. 

Sample Certifications

  • ECBA
  • CCBA
  • CBAP
  • PMI-PBA

Business analyst healthcare claim resume sample

The advert below is for a Healthcare Business Analyst (Claims) for CalOptima, a county-organized health system that administers health insurance programs for low-income children, adults, seniors, and people with disabilities.

You will see that the job requires analytical, claims expertise and there are substantial administrative responsibilities that relate to this.

The applicant is expected to have a thorough knowledge of the programs that CalOptima uses, specifically Medi-Cal, Crossover Medicare, and OneCare Connect.

The healthcare business analyst’s responsibilities are clearly outlined. You will see that all the primary responsibilities are claim related.

Skills, experience, education, and other required areas of knowledge are also clearly outlined. An important requirement is two years of experience related to Medicare and Medi-Cal billing plus claim adjudication. Experience of medical coding is also needed. 

Business analyst healthcare claim specialist

Objective

Dedicated business analyst specializing in healthcare. Five years of experience working with Medicare and Medi-Cal billing including claims adjudication. Extensive experience in medical coding. Proficient in claims processing systems. Self-starter ready to collaborate. 

Skills

Time management | Data and quantitative analyses | Monitoring and testing | Communication | Problem-solving | Computer software – Microsoft Office | ICD-10-CM & ICD-10-PCS | CPT | HCPCS | Diagnostic Related Group (DRG) coding system.

Molina Healthcare, CA

Analyst Business Systems (Claims Testing), 2018 – 2020

Assisted the company’s business teams with developing requirements for major projects. Coordinated and managed teams in the development of large multi-system and multi-platform projects. Assistance was provided when required. 

  • Prepared system design specifications and conducted research to resolve customer-initiated issues relating to Medicaid and Medicare claim processing. 
  • Worked closely with customers to develop requirements for major projects of considerable complexity.
  • Prepared general system design specifications. Created, reviewed, analyzed, and estimated project requests.
  • Researched and analyzed customer-initiated inquiries and requests utilizing technical tools as necessary to debug and/or analyze problems.

SCAN Group

Health Care Analyst II, 2016 – 2017

Worked under supervision in risk adjustment analytics for the largest not-for-profit Medicare Advantage plan company. The focus was on keeping seniors healthy and independent. 

  • Responsible for research and moderate analysis of Medicare Advantage and healthcare data specific to membership, provider, claims, authorizations, pharmacy, and financial information.
  • Conducted data management, quality improvement studies, statistical analyses, and report generation. Presented findings to higher-level analysts as well as HCI mid and senior management.
  • Performed moderate to complex analysis and interpreted organizational data, including, but not limited to data mining, data verification, mapping, scrubbing, and scrapping.
  • Conducted investigative research to uncover root causes, interpret results, identify trends, and make recommendations for action.
  • Supported customer needs for what-if scenario analysis by developing analytical tools/models.
  • Conducted informal training, provided guidance, and supported lower-level analysts. Mentored 3 analysts for six months each.

UnitedHealth Group, CA

Business Analyst Intern, 2015

Three-month summer internship reporting to the Corrective action Preventative Action manager. Responsible for assessing errors identified in audits. Worked with a senior analyst to develop process improvement opportunities. 

  • Assisted with root cause analysis of errors identified in audits and developed action plans. 
  • Assisted with quality assurance testing the accuracy and effectiveness of process improvements.
  • Shadowed and assisted the senior analyst in completing the  error impact analysis.
  • Lead a special project and made 5 recommendations for process improvement and 2 innovative solutions to the challenges presented.

Certifications

  • ECBA
  • CCBA

Education

University of California, Berkeley

Bachelor of Science in Business Administration, 2000 – 2009

Courses 

  • Advanced Business Analysis
  • Certified Business Analysis Professional (for CCBA recertification)
  • Coding for Medical Office Applications

Key Takeaways

You’ll need to work on showing how your healthcare business analyst training, skills, and experience qualify you for the job you are applying for. Pay special attention to the requirements of the job and remember that no two jobs are ever exactly the same.

  • You don’t have to include a resume objective in your document but it can help to draw attention to you as a suitable applicant. If you include one, keep it short and highlight how you will add value to the position. 
  • Briefly list your skills, focusing on those that match the job description.  
  • Work experience is important, but only include experience that is relevant to the job you are applying for. Wherever possible include achievements as well as stand-out responsibilities. 

Tips from Experts

“A resume is a marketing tool and an extension of your professional brand. An effective resume showcases your experience, achievements and strengths, relating them to a specific position by using keywords and highlighting relevant experiences. Remember, there is no one “correct” resume for you to use – the best resume is the one that clearly and effectively communicates your skills, abilities, and future potential.” University of Delaware Career Center

“While it may be easier to snap a “selfie” than to write one, it’s worth a little time and effort to make your resume the best picture of yourself it can be. This is your opportunity to show a potential employer the experience, education, and skills that make you qualified for the job.” – American College for Medical Careers, 10 Resume Tips for Healthcare Jobs

“Producing a good resume and a well-written cover letter is a basic requirement for any successful job search. These documents play a critical role in helping employers understand who you are, what motivates you, and what you have to offer as a potential employee.” – University of California, Berkeley Career Center

Conclusion

Never use the same resume for every job you apply for. There’s nothing wrong with having a standard resume that you can use as a kind of template. But you must tailor it to fit the needs of the job you are applying for.

Methodology

In addition to our own expertise as professional resume consultants, for every resume guide we write, we curate dozens of recent job postings and resumes to make sure all our recommendations align with current trends for each specific industry and career path. Learn more about our methodology here. 

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