Business Analyst (US healthcare - Claim Processing)

Job Description

Business Analyst - Claims Experience: 8-9 years Job Description: ? Candidate must have worked in US healthcare with experience minimum of 8 years of experience, especially in claims application as a 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 possess 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 the complex business problems and 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 have 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 ? Preferable to have basic SQL knowledge ? Soft spoken, thrive to learn and willing to work in flexible timing, and may require to work on weekend as per business need