Lead Business Analyst

Job Title: Lead II -Business Analyst

Experience: 7 to 9 years

Work Location: Kochi, Trivandrum

Key Responsibilities & Deliverables:

Analyze the business needs of a client in order to recommend and evaluate solutions to those needs independently. Perform Business Analysis tasks independently and be able to guide junior BAs.

Key Responsibilities & Deliverables

1. Use analytical skills and judgment to identify, prioritize, structure, and solve complex problems.
2. Work closely with the customer to understand and define enterprise goals and objectives.
3. Immensely contribute to the sprint planning and estimation by highlighting dependencies, constraints impact from a business standpoint.
4. Be the face of the team to the customer and act as an SME for all of the business and strategic needs.
5. Understand and use BA knowledge areas appropriately as required by the business problem.
6. Analyze business needs and solutions. Devise strategies and facilitate stakeholder collaboration effectively and efficiently.
7. Validate and verify information to identify solution options that meet business needs.
8. Align the designed and delivered solutions with stakeholder needs.
9. Establish and implement effective requirement creation and management practices.
10. Champion requirements Elicitation using proven techniques like interviews, document analysis, requirements workshops, storyboards, surveys, site visits, business process description,s use cases, scenarios, event list, competitive product analysis task and workflow analysis, and/or viewpoints.
11. Define the solution approach, identify business improvement opportunities, allocate requirements across solution components, and develop design options that achieve the desired future state.
12. Define software quality attributes, external interface constraints, and other non-functional requirements.
13. Monitor the market for technologies/processes to manage business analysis Information.
14. Develop training materials and "tips" that stakeholders can leverage to improve their efficiency in using business analysis tools.
15. Work with large or multiple teams that span functions, issue locations, and time zones to coordinate roles, responsibilities, and interdependencies of all team members.
16. Develop a network of Subject Matter Experts (SMEs) inside and outside of the organization.
17. Develop an innovative approach for using new tools, templates, and processes.
18. Develop engagement strategies to support organizational transformation.
19. Be able to assist in driving transformational program(s) for the organization's/customer's enterprise.

Requirement:

We are seeking a highly skilled and detail-oriented BA with specialist RCM knowledge to help in detailing requirements for end-to-end revenue cycle operations. The ideal candidate will have hands-on experience across front-end, mid-cycle, and back-end RCM processes, with a strong understanding of payer requirements, coding standards, and claims workflows.

Front-End RCM

• Patient registration and intake with accuracy

• Insurance eligibility and benefits verification

• Prior authorization processes and coverage validation

• Documentation of medical necessity and payer requirements

Mid-Cycle RCM

• CPT, ICD-10, HCPCS, J-Codes, and SNOMED

• Specifics for submission of 837P and 837I

• Understand payer-specific rules and clean claim submission

• Denials and resubmissions with appropriate documentation

Back-End RCM

• Posting payments and Reconciliation of claims using ERA and EOBs

• Analysis of payment variances and resolution of discrepancies

• Management of patient balances and coordination of billing follow-ups

• Resolution process with finance and customer service teams

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