Task & Process Mining Analyst – Healthcare Claims

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

📋 Description

• Implement and configure process mining solutions to examine healthcare claims event-log data and reconstruct comprehensive process flows.

• Capture and evaluate user interactions at the desktop level across claims intake, validation, adjudication, remittance, and denial workflows.

• Identify process variations, bottlenecks, rework cycles, manual intervention points, and compliance discrepancies.

• Develop and sustain process mining dashboards and conformance models.

• Produce data-driven as-is process documentation reflecting actual execution.

• Assess healthcare claims workflows, including EDI 837/835, eligibility verification, prior authorization, submission, adjudication, remittance, denials, and appeals.

• Analyze payer-provider interactions and the underlying causes of denials, delays, rework, and manual interventions.

• Quantify volumes, cycle times, error rates, rework, and manual effort to support ROI and business cases.

• Collaborate with subject matter experts (SMEs) in claims, clinical teams, billing teams, and operational stakeholders.

• Translate mining insights into automation opportunities while defining scope, estimates, benefits, and ROI.

• Create Process Definition Documents and provide solution-design inputs for RPA teams.

• Prioritize opportunities based on volume, complexity, compliance risk, and business value.

• Work closely with UiPath developers and architects during process discovery and automation development.

• Present findings, dashboards, insights, and business cases to healthcare operations and IT stakeholders.

• Facilitate stakeholder workshops and validate both current-state and future-state processes.

• Assist in change management and process transformation throughout implementation.

• Establish process mining models, prioritize high-value automation initiatives, decrease denials, rework, and manual processing time, and enable decision-making driven by dashboards.

⛳️ Requirements

• Over 5 years of experience in business/process analysis, with a minimum of 2 years dedicated to healthcare claims operations.

• Practical experience with UiPath Process Mining and/or Task Mining, or similar tools such as Celonis, Minit, or Fluxicon Disco.

• In-depth knowledge of the healthcare claims lifecycle, including EDI 837/835, eligibility, prior authorization, adjudication, denials, remittance, and appeals.

• Familiarity with healthcare claims platforms such as Epic Resolute HB/PB, Facets, TriZetto, Availity, or Change Healthcare.

• Proficient in process mapping and documentation tools like Visio or Lucidchart.

• Strong analytical abilities, encompassing event-log/process data analysis and ROI modeling/business-case formulation.

• Understanding of HIPAA compliance and requirements for handling PHI.

• Experience with RPA platforms, ideally UiPath, and knowledge of the automation development lifecycle.

• Excellent communication, stakeholder management, and problem-solving capabilities.

🏝️ Benefits

• Competitive salary and performance-based bonuses.

• Comprehensive health, dental, and vision insurance plans.

• Opportunities for professional development and continuous learning.

• Flexible working hours and remote work options.

• Collaborative and inclusive work environment.