Senior Healthcare Business Solutions Specialist

3 days ago


Tirupati, Andhra Pradesh, India beBeeRegulatory Full time ₹ 15,00,000 - ₹ 20,00,000
Healthcare Business Analyst

We are seeking a skilled Healthcare Business Analyst to join our team. As a key member of our organization, you will be responsible for gathering and analyzing business requirements related to healthcare regulations.

  • Gather and Analyze Requirements: Gather, analyze, and document business requirements related to HIPAA, CMS, NCQA, and state-specific regulations.
  • Ensure Compliance: Ensure system changes, processes, and documentation remain compliant with healthcare regulations and payer guidelines.
  • Liaise with Teams: 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 System Integration: Support plan design, benefit mapping, and validation in healthcare systems (e.g., Facets, QNXT, or other payer platforms).
  • Collaborate with Teams: Collaborate with product and IT teams to ensure accurate coding, claims adjudication, and eligibility processing.
  • Coordinate Development: 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 Teams: Partner with marketing and compliance teams to ensure content accuracy, regulatory alignment, and timely delivery.
  • Track Versioning: Track versioning and approvals of collateral to maintain consistency across all distribution channels.

This is an exciting opportunity to work with a talented team and make a real impact in the healthcare industry. If you are a motivated and detail-oriented professional with excellent analytical skills, we encourage you to apply.



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