Business Analyst – Healthcare

This is a fully remote position, open to applicants in India.

📋 Description

• Analyze, design, and document business requirements pertaining to healthcare claims, reference data, and code sets.

• Collaborate with stakeholders to gather and define requirements related to ICD, CPT, HCPCS, UB‑04, revenue codes, provider taxonomy, and other healthcare reference data.

• Create and maintain business analysis artifacts such as BRDs, functional specifications, process flows, decision tables, and traceability matrices.

• Convert business, policy, and coding requirements into clear functional objectives for technical teams.

• Conduct impact analysis for code-set modifications, regulatory updates, and policy changes affecting claims processing systems.

• Assist in testing activities, which include defining test scenarios and validating system outputs.

• Engage in technical reviews and project discussions to ensure alignment of requirements throughout lifecycle phases.

• Identify opportunities for enhancing business processes and improving data governance.

• Work collaboratively with developers, testers, and stakeholders for issue resolution, defect triage, and root-cause analysis.

• Effectively communicate with both business and technical teams through documentation, meetings, and presentations.

⛳️ Requirements

• 6–10 years of experience in a Business Analyst role.

• Extensive experience in the healthcare domain (Medicaid / Medicare / claims processing).

• Proficient knowledge of healthcare code sets, including ICD‑10‑CM, ICD‑10‑PCS, CPT, HCPCS, UB‑04 institutional billing elements, revenue codes, modifiers, type of bill, and place of service.

• Experience in gathering, analyzing, and documenting requirements.

• Strong understanding of the claims lifecycle, adjudication processes, and reference data workflows.

• Familiarity with SDLC processes, testing, and system configuration concepts.

• Excellent analytical and problem-solving abilities.

• Proficient in Microsoft Excel and data analysis tools.

• Strong communication skills and adept at stakeholder management.

• Preferred Skills: Experience with MMIS systems or healthcare program implementations; knowledge of HIPAA transactions and X12 claims (837, 835, etc.); experience with SQL for data analysis and validation; familiarity with ALM tools, Jira, ServiceNow, or similar platforms; experience in data governance, reference-data management, or claims edits/billing rules; exposure to regulatory compliance and healthcare audits; business analysis certifications or healthcare coding knowledge.

🏝️ Benefits

• Remote work environment with shift time (2 pm - 11 pm IST).