▷ [3 Days Left] US Healthcare Business Analyst

1 week ago


Pune, India AS Technology Corporation Full time

- Minimum 5 years of experience as a Business Analyst (or similar role) in the US healthcare industry, with significant exposure to claims processing and enrollment/eligibility workflows. - Strong understanding of health plan operations: claims adjudication lifecycle, denials/appeals, provider networks, eligibility/enrollment, member onboarding, payer/provider contracts. - Proven experience working with enrollment/eligibility systems and/or claims management systems (e.g., EDI transactions (837/835/277 etc.), provider portals, clearinghouses) is highly desirable. - Strong analytical skills: able to work with data (SQL, Excel, BI tools) to identify trends, root‐causes, produce reports and dashboards. - Ability to document business requirements, functional specifications, user stories, process flows, and acceptance criteria with clarity. - Experience in UAT/test planning, test case creation, collaborating with QA/Dev teams. - Excellent stakeholder management – ability to liaise with operations, IT, product, compliance and leadership teams and translate business needs into technical solutions. - Good communication skills (written and verbal), comfortable presenting to senior leadership. - Familiarity with regulatory environment (HIPAA, CMS, ACA, HEDIS, etc) and familiarity with audit/compliance process. - Preferable: Experience with Agile/Scrum methodologies and associated tools (JIRA, Confluence). - Preferable: Experience with data warehousing, BI dashboards, process automation (RPA) or system upgrades/migrations in the healthcare payer space.



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