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Description:

Client organizations hire healthcare business analysts to bridge business needs with data-driven solutions across health operations, Enrollment services, Claim processing and payer processes. A typical description emphasizes collaboration with Enrollment teams, Claims and provider domains , and IT teams to translate complex healthcare requirements into actionable data analytics and process improvements.

Key Responsibilities:

+ Min 7+ years of experience in healthcare business analyst role, especially in data profiling and data management.

+ Domain Knowledge:

+ Well versed with the Enrollment processes in Healthcare Business, from the start of an enrollment process until a policy is attained.

+ Should have a Complete understanding of the life cycle of a claim, clear knowledge on the claim adjudication and settlement. This includes both Medical and pharmacy claims.

+ Understanding of the provider domain and its relationship with the claims processing.

+ Data Management: Design and maintain data warehouses, creating robust ETL processes to integrate data from enrollment, claims, billing, provider and other third party vendors etc..

+ Experience and knowledge in MS SQL to extract, manipulate, and analyze large datasets to provide actionable business insights.

+ Conducts elicitation meetings to understand business requirements and prepare a detailed requirement document with all relevant details.

+ Profile data and prepare a mapping spreadsheet for every data element.

+ Collaborates with the stakeholders to analyze, evaluate and implement changes in the system for better results.

+ Conducts solution evaluation to assess the value realization and designs improvements, if value is not realized.

+ Perform user acceptance testing and support business during testing phase.

+ Be liaison between business SMEs and IT teams during the entire project and ensure process adherence.

+ Prepare detailed documentation post project of what was included/changed.

+ Co-ordinate with the external teams/Vendors to verify the end user needs are fulfilled.

+ Take ownership of end-to-end deployment.

+ Familiarity with Agile methodologies (Azure) and project management practices.

+ Experience in report generation using Tableau/PowerBI.

Soft Skills:

+ Excellent problem-solving and analytical skills.

+ Strong communication skills and the ability to work effectively with cross-functional teams.

+ Attention to detail and a commitment to producing high-quality work.

What Makes HTC A Great Place To Build Your Future

HTC Global Services wants you to join our team. Come build new things with us and advance your career. At HTC Global, you’ll collaborate with experts, work alongside clients, and be part of high-performing teams driving success together. You’ll have long-term opportunities to grow your career and develop skills in the latest emerging technologies.

At HTC Global Services, our employees have access to a comprehensive benefits package. Benefits can include Group Health (Medical, Dental, and Vision), Paid Time Off, Paid Holidays, 401(k) matching, Group Life and Disability insurance, Professional Development opportunities, Wellness programs, and a variety of other perks.

Our success as a company is built on inclusion and diversity. HTC Global Services is committed to providing a workplace free from discrimination and harassment, where every employee is treated with dignity and respect. We celebrate differences and believe that diverse cultures, perspectives, and skills drive innovation and success. HTC is an Equal Opportunity Employer and a proud National Minority Supplier. We seek to empower each individual, fostering an environment where everyone feels valued, included, and respected.

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