Healthcare Domain Specialist

5 days ago


Alwar, Rajasthan, India beBeeRegulator Full time ₹ 80,00,000 - ₹ 1,20,00,000
Job Description\

As a senior business analyst with expertise in healthcare, you will play a vital role in shaping the strategic direction of our organization's healthcare initiatives.

\Key Responsibilities:\
  • \
  • 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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