Senior Business Analyst - Claims; Payer

Position: Senior Business Analyst - Claims (Payer)
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