JD - SOG Technical BA:
We are seeking a detail-oriented and experienced Business Analyst to join our health insurance team. The ideal candidate will bridge the gap between business needs and technical solutions, ensuring that projects meet stakeholder expectations while adhering to regulatory compliance. The role involves analyzing business processes, gathering requirements, and facilitating system and process enhancements.
Key Responsibilities:
Requirements Gathering and Analysis:
- Collaborate with stakeholders to identify and document business needs, goals, and challenges.
- Analyse and document requirements for health insurance products, claims, enrolment, eligibility, and benefits.
- Ensure requirements align with regulatory standards such as HIPAA, ACA, or HL7 -FHIR standards
Process Improvement:
- Evaluate existing workflows and recommend process enhancements to improve efficiency and customer satisfaction.
- Work on automation projects, including policy administration, claims processing, and member on boarding.
- Identify bottlenecks and propose solutions to streamline health insurance operations.
System Implementation and Support:
- Serve as a liaison between business units and IT teams during system upgrades or implementations.
- Develop detailed functional specifications, use cases, and user stories.
- Test system changes to ensure accuracy, reliability, and compliance with business requirements.
Data Analysis and Reporting:
- Analyze large datasets related to health insurance policies, claims, member enrolments, and benefits utilization.
- Prepare detailed reports and dashboards to support decision-making.
- Ensure data quality and integrity in reporting processes.
Stakeholder Engagement:
- Communicate effectively with internal teams, external vendors, and clients to ensure alignment on project objectives.
- Conduct workshops and training sessions for stakeholders on new systems, processes, or policy changes.
- Provide post-implementation support and troubleshoot issues as they arise.
Technical Skills:
- Background should be a doctor
- Proficiency in health insurance platforms such as Facets, QNXT, or Epic.
- Strong knowledge of tools like JAVA,SQL, Excel, Power BI, Tableau, or other data visualization tools.
- Understanding of APIs and system integrations for health insurance.
- Exposure to health insurance policy lifecycle management.
- Experience working with Agile and Waterfall project methodologies.
- Understanding of medical billing codes (ICD, CPT, HCPCS,IRDRG ).
Domain Knowledge:
- In-depth understanding of health insurance concepts, including enrolment, eligibility, premium calculation, benefits, and claims processing.
- Familiarity with health insurance regulations and compliance standards.
Soft Skills:
- Strong analytical and problem-solving skills.
- Excellent written and verbal communication abilities.
- Ability to manage multiple tasks and work under tight deadlines
Pay: Up to ₹1,500,000.00 per year
Benefits:
- Flexible schedule
- Paid sick time
- Provident Fund
Work Location: In person
