Technical Business Analyst - Pharmacy Claims

Technical Business Analyst – Pharmacy Claims

Location: Pittsburgh, PA (Hybrid)

About eNGINE

eNGINE builds Technical Teams. We are a Solutions and Placement firm shaped by decades of interaction with Technical professionals. Our inspiration is continuous learning and engagement with the markets we serve, the talent we represent, and the teams we build. Our Consulting Workforce is encouraged to enjoy career fulfillment in the form of challenging projects, schedule flexibility, and paid training/certifications. Successful outcomes start and finish with eNGINE.

Role Overview

eNGINE is seeking a Technical Business Analyst with hands-on experience supporting pharmacy claims processing. This role is ideal for someone who understands how pharmacy claims move through the adjudication process, can quickly identify why claims reject, and enjoys working directly with customers to solve technical and operational challenges.

You'll serve as the bridge between customers, product, and engineering teams by owning the data pipelines that support customer implementations and ongoing production operations. This position combines business analysis, SQL-driven data investigation, production support, and customer interaction, making it an excellent fit for someone with both functional pharmacy knowledge and strong technical aptitude.

Duties & Responsibilities

• Serve as the technical point of contact for pharmacy claims processing and customer implementations.
• Own customer data pipelines from initial implementation through ongoing production support.
• Investigate pharmacy claim failures and rejection reasons, determine root cause, and coordinate timely resolution.
• Analyze pharmacy claims data using SQL to troubleshoot production issues and validate customer data.
• Work directly with insurance companies, PBMs, pharmacies, and internal stakeholders to resolve complex claims questions.
• Translate business requirements into clear technical documentation for development teams.
• Partner with engineering to improve system functionality, data quality, and operational efficiency.
• Support software deployments, testing, and production releases while ensuring data accuracy.
• Identify recurring claim issues and recommend process improvements to reduce customer-impacting defects.

Qualifications

• 4+ years of experience as a Technical Business Analyst, Business Analyst, or similar technical support role.
• Working knowledge of pharmacy claims processing, including claim lifecycle, adjudication, and common rejection reasons.
• Experience researching and explaining pharmacy claims rejection codes and working through claim resolution.
• Strong SQL skills with the ability to query relational databases to investigate data and production issues.
• Experience supporting external customers, including insurance companies, PBMs, pharmacies, or other healthcare organizations.
• Excellent analytical and troubleshooting abilities.
• Strong communication skills with the ability to work effectively across technical and business teams.

Preferred Experience

• Experience supporting pharmacy claims platforms or healthcare software products.
• Strong understanding of pharmacy benefit workflows and claims adjudication.
• Advanced SQL skills, including joins, subqueries, views, and data validation techniques.
• Experience working with APIs, data integrations, or customer-facing data pipelines.
• Exposure to scripting languages such as Python or PowerShell.
• Experience working in Agile software development environments.
• Familiarity with application support, production issue management, and root cause analysis.
• Experience creating technical documentation, business requirements, and process flows.

Next Steps

No C2C, relocation, referral, or sponsorship candidates for this role.

For finer details on how eNGINE can impact your career, apply today!