Role description
Job Description - Analyst / Sr. Analyst
Process: Product Config (US Healthcare - Payer)
Experience: 5+ Years (Mandatory)
Shift: 5:30 PM - 2:30 AM IST (Night Shift)
Work Mode: 5 Days Work from Office
Location: India (Trivandrum /Chennai)
Joining: Immediate
Role Summary
We are looking for a Product Config Analyst to support US Healthcare operations in a BPO environment. The role focuses on creation, validation, and maintenance of member-facing benefit documents (Contracts & Booklets) aligned with benefit configuration and product setup. The candidate must have strong benefit interpretation skills and hands-on experience in payer-side configuration and documentation processes.
Key Responsibilities
- Create Product Setup documents & designs
- Develop document components such as:
- Schedule of Benefits (Copay, Deductible, Coinsurance)
- Riders and benefit sections
- Preventive schedules and plan details
- Ensure documents meet client formatting, regulatory, and compliance standards
- Interpret benefit designs from product configurator / payer systems
- Convert system configurations into accurate member-facing documents
- Validate cost share elements against configured benefits:
- Copay / Coinsurance / Deductible / OOP
- Ensure alignment across configuration, schedule, and filing documents
- Perform QA validation of contracts and booklets before production release
- Conduct checks such as:
- Schedule vs Product Config comparison
- Filing vs Template validation
- Maintain high accuracy and quality benchmarks
- Manage end-to-end workflow:
- Intake via ticketing system
- Template extraction and mapping
- Document creation and QA
- Final production release
- Handle volumes with SLA adherence and turnaround commitments
- Work closely with:
- Benefit Configuration teams
- QA and Testing teams
- Client stakeholders (onshore/offshore)
- Support testing, appeals, and audit queries with document references
- Identify gaps in documentation and configuration mapping
- Support automation, standardization, and process efficiency initiatives
- Contribute to SOPs, QA checklists, and process documentation
Eligibility & Qualifications
- 3+ years in US Healthcare Payer operations
- Mandatory experience in Benefit Configuration / Product Configuration
- Hands-on exposure to:
- Contracts & Booklets
- Benefit documentation / Plan setup
Required Skills
- Strong knowledge of:
- Health plan benefits (Copay, Deductible, Coinsurance, OOP, Accumulators)
- Commercial / Medicare plan structures
- Understanding of:
- Benefit configuration workflows
- Plan design & document mapping
Technical Skills
- Experience with payer tools like:
- Product Configurator / Benefit Systems
- HighRoads / P2A / FOS (or similar platforms)
- Good working knowledge of:
- MS Word (document editing & formatting)
- Excel (validation & mapping)
Behavioral Skills
- High attention to detail and accuracy
- Analytical thinking and problem-solving ability
- Strong written and verbal communication
- Ability to work in fast-paced production environment
Preferred Skills
- Experience in:
- Contract & Booklet creation / audit
- Benefit testing / appeals support
- Exposure to payer platforms:
- Facets / QNXT / HealthRules
- Knowledge of compliance and regulatory guidelines
Key Competencies
- Accuracy & Quality Focus
- Benefit Interpretation Expertise
- Stakeholder Communication
- SLA & Delivery Ownership
- Continuous Improvement Mindset
Skills
healthcare payor,us healthcare,regulatory domain,qnxt,coinsurance,benefits configuration,quality assurance,
About UST
UST is a global digital transformation solutions provider. For more than 20 years, UST has worked side by side with the world’s best companies to make a real impact through transformation. Powered by technology, inspired by people and led by purpose, UST partners with their clients from design to operation. With deep domain expertise and a future-proof philosophy, UST embeds innovation and agility into their clients’ organizations. With over 30,000 employees in 30 countries, UST builds for boundless impact—touching billions of lives in the process.
