Senior Business Analyst

14 hours ago


Kannur, Kerala, India beBeeRegulations Full time ₹ 15,00,000 - ₹ 21,35,000

Healthcare Business Intelligence Specialist

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  • Key Responsibilities include gathering, analyzing and documenting business requirements related to HIPAA, CMS, NCQA and state-specific regulations.
  • We are seeking a professional who can ensure system changes, processes and documentation remain compliant with healthcare regulations and payer guidelines.
  • As Healthcare Business Intelligence Specialist, you will 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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