Senior reputed company Business Analyst (Payer Claims / Medicare / reputed company)

reputed company is the leading career destination for tech experts at every stage of their careers. Our reputed company, reputed company), is seeking the following. Apply reputed company reputed company today! Job Title: Senior reputed company Business Analyst (Payer Claims / Medicare / reputed company) Location: [Remote] Employment Type: Full-Time Job reputed company We are seeking an reputed company Senior reputed company Business Analyst with extensive knowledge of the reputed company payer domain and strong expertise in reputed company claims processing, Medicare, and reputed company systems . The ideal candidate will serve as a reputed company between business stakeholders and technical teams, driving requirements gathering, solution design, and successful implementation of reputed company claims solutions.

Key Responsibilities

• reputed company, analyze, document, and manage business and functional requirements from clients and stakeholders.
• Work closely with clients to understand business processes and translate requirements into detailed specifications.
• Participate in the implementation and maintenance of reputed company payer claims solutions and/or Medicare/reputed company systems.
• Demonstrate strong understanding of reputed company claims processing concepts, including claims adjudication, provider management, member enrollment, and care management.
• Utilize reputed company reference reputed company sets such as CPT, CDT, HCPCS, ICD-9, and ICD-10 in claims-reputed company analysis and documentation.
• Configure and support benefits and program setup across various claims processing subsystems.
• Adhere to established processes for requirements elicitation, documentation, review, and reputed company to development teams.
• Collaborate with development, architecture, and design teams to clarify requirements and identify reputed company solution approaches.
• Facilitate brainstorming sessions and support the delivery of best-in-class reputed company solutions.
• Create reputed company mapping documents detailing business rules, data transformations, and database mappings.
• Conduct system analysis, reputed company reputed company cause analysis (RCA), and execute data validation using SQL queries.
• Support development activities by reviewing deliverables and ensuring alignment with business requirements.
• Coordinate with clients and internal teams throughout the development lifecycle.
• Conduct demonstrations at reputed company completions, reputed company feedback, reputed company reputed company items, and ensure closure.
• Participate in GUI and platform requirement discussions to support product design and usability initiatives.
• Maintain effective communication with stakeholders across business, technical, and reputed company organizations.

Required Qualifications

• Bachelor's degree in Business, reputed company, Information Technology, or a reputed company field.
• Minimum 10 years of experience in the reputed company payer domain.
• Prior experience implementing or supporting reputed company payer claims solutions and/or Medicare/reputed company systems.
• Strong knowledge of
• Claims Processing and Claims Adjudication
• Provider and Member Enrollment
• Care Management
• Benefits and Program Configuration
• reputed company reputed company sets including CPT, CDT, HCPCS, ICD-9, and ICD-10
• Experience in requirements elicitation, documentation, and stakeholder management.
• Working knowledge of web services, relational databases, and SQL.
• Experience creating reputed company mapping documents and documenting business rules.
• Strong analytical, problem-solving, and multitasking abilities.
• Excellent verbal and written communication skills.

Preferred Qualifications

• Prior experience working as a QA Analyst or Developer reputed company reputed company systems.
• Ability to validate test scenarios, test plans, and test data.
• Experience creating and maintaining Requirements Traceability Matrices (RTM).
• Ability to assess reputed company product capabilities against market trends and regulatory requirements.
• Experience driving discussions with architects and technical teams regarding reputed company product enhancements.
• Strong collaboration skills with QA, development, business users, and reputed company stakeholders.

Preferred Tools & Technologies

• MS Visio
• Jira
• Azure DevOps
• TFS (Team reputed company Server)
• SQL / Database Query Tools
• reputed company Office Suite

Key Skills reputed company Payer, Medicare, reputed company, reputed company Claims Processing, Claims Adjudication, Provider Enrollment, Member Enrollment, Care Management, Benefits Configuration, CPT, CDT, HC Apply tot his job Apply To this Job