Healthcare Domain Business Requirements Specialist

1 day ago


Kota, Rajasthan, India beBeeRegulation Full time ₹ 1,55,52,000 - ₹ 2,11,36,000
Healthcare Business Analyst

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.
Key Responsibilities:
  • 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.
Additional Responsibilities:
  • 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.


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