Job Title

Job Role : Business Analyst - Claims (Payer) Experience : 7-12 Years Work Location: Chennai / Hyderabad Work Model : Hybrid Expectations : Looking for BA Functional candidates who worked in Claims specifically in US Healthcare Payer side.Role Expectations: Candidate must have worked in US healthcare with experience minimum of 7 years, especially in claims application as business analyst or consultant. Membership and provider domain knowledge/experience is preferable, but must have claims knowledge FEP, ITS (Interplan Teleprocessing system)/Blue card claims and B2 application knowledge/experience is preferable. Work experience in EHR/EMR is also considered, but must have worked or possessed knowledge of claims submission to Payers Should have knowledge in working with all types of claims – medical, hospital, Pharmacy, Dental, Vision, Blue card/ITS etc Should have the fundamentals of requirement gathering, elicitation, documenting, and transition over to internal and external stakeholders Should have experience in writing functional specification documents/BRD Should have ability to solve complex business problems and be exposed to complete software development life cycle (SDLC) Should have sound knowledge in claims testing end to end, work under minimal supervision and take complete ownership of delivery Sound knowledge of current US federal and state laws with regards to healthcare governance and policies, and preferable to have PAHM/FAHM certifications or working towards certification Business Analysis knowledge is mandatory, and preferable to have certifications like CBA/CBAP or working towards certification Nice to have work exposure with agile and scrum teams Preferably to have basic SQL knowledge Soft spoken, thrive to learn and willing to work in flexible timing, and may require working on weekend as per business need