This role is for one of Weekday’s clients
Salary range: Rs 1500000 - Rs 3000000 (ie INR 15 - 30 LPA)

Min Experience: 8+ years
Location: Hyderabad, Chennai, Tamil Nadu, India
JobType: full-time

We are looking for an experienced Business Analyst with 8–14 years of experience and strong expertise in the US Healthcare domain, particularly payer operations and healthcare claims. The ideal candidate will act as a bridge between business stakeholders, healthcare operations, technology teams, and product teams to translate complex business requirements into clear, actionable solutions.

The candidate should have a strong understanding of the US healthcare ecosystem, payer processes, claims lifecycle, and healthcare business workflows. Experience working on large-scale healthcare projects and collaborating with cross-functional teams is highly desirable.

Requirements

Key Responsibilities

• Gather, analyze, document, and validate business requirements from healthcare stakeholders, business users, and subject matter experts.
• Work extensively on US Healthcare payer processes, including claims intake, adjudication, pricing, payment, denials, adjustments, and appeals.
• Develop a deep understanding of healthcare claims workflows, payer operations, member benefits, eligibility, providers, and reimbursement processes.
• Collaborate with product managers, project managers, developers, QA teams, and business stakeholders to translate business needs into functional requirements.
• Analyze existing business processes and identify opportunities for process improvements, automation, and operational efficiency.
• Conduct requirement-gathering sessions, stakeholder interviews, workshops, and process walkthroughs.
• Create detailed business and functional requirement documentation, process flows, use cases, user stories, and acceptance criteria.
• Support development and testing teams by clarifying requirements and resolving functional queries throughout the project lifecycle.
• Review and validate proposed solutions to ensure alignment with business requirements and healthcare industry standards.
• Participate in UAT planning, test-case reviews, defect analysis, and business validation.
• Identify gaps between current-state and future-state processes and recommend practical solutions.
• Manage communication across business and technical teams to ensure clear understanding of requirements and project objectives.
• Support project teams during implementation, production deployment, and post-production stabilization.
• Ensure requirements and deliverables are aligned with applicable US Healthcare payer and claims processes.

Must-Have Skills

• 8–14 years of experience as a Business Analyst, preferably within the US Healthcare industry.
• Strong hands-on experience in US Healthcare.
• Strong understanding of Healthcare Payer processes and operations.
• Extensive knowledge of Healthcare Claims, including claims processing, adjudication, denials, adjustments, and payment workflows.
• Experience gathering and analyzing complex business requirements.
• Strong stakeholder communication and management skills.
• Ability to work effectively with business, product, technology, QA, and operations teams.
• Strong analytical, problem-solving, and documentation skills.
• Experience working in Agile and/or Waterfall project environments.

Good-to-Have Skills

• Experience creating BRD (Business Requirements Documents) and functional requirement specifications.
• Knowledge of healthcare eligibility, benefits, provider, and member management processes.
• Experience with process mapping, workflow documentation, and gap analysis.
• Exposure to healthcare claims platforms, payer systems, or related enterprise applications.
• Familiarity with SQL or data analysis tools is an advantage.