Senior Business Analyst with HealthCare

4 weeks ago

Bikaner, Rajasthan, India Technocrats Domain Inc Full time
Business Analyst – Healthcare Domain
  • Gather, analyze, and document business requirements related to HIPAA, CMS, NCQA, and state-specific regulations.
  • Ensure system changes, processes, and documentation remain compliant with healthcare regulations and payer guidelines.
  • Act as liaison with compliance and legal teams during audits or regulatory updates.
  • Benefit Codes & Plan Configuration
  • Analyze and configure benefit codes for medical, dental, pharmacy, and specialty products.
  • Support plan design, benefit mapping, and validation in healthcare systems (e.g., Facets, QNXT, or other payer platforms).
  • Collaborate with product and IT teams to ensure accurate coding, claims adjudication, and eligibility processing.
  • Collateral & Member Materials
  • Coordinate development and validation of member-facing collateral such as Explanation of Benefits (EOBs), Summary of Benefits and Coverage (SBCs), provider directories, and plan brochures.
  • Partner with marketing and compliance teams to ensure content accuracy, regulatory alignment, and timely delivery.
  • Track versioning and approvals of collateral to maintain consistency across all distribution channels.

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