Claims Business Analyst - Healthcare

📋 Description

• Partner with healthcare operations and IT stakeholders to assess current-state claims processes and
• Analyze the end-to-end claims lifecycle, including eligibility verification, claims submission
• Evaluate EDI 837/835 workflows to identify process gaps, manual interventions, rework, bottlenecks
• Investigate root causes of claim denials, inaccuracies, and operational inefficiencies and develop
• Identify opportunities for process standardization, optimization, RPA, AI/ML, and intelligent
• Leverage process intelligence and task/process mining solutions such as UiPath, Celonis, or

🎯 Requirements

• 5+ years of experience in healthcare claims, healthcare operations, business analysis, or business
• Strong understanding of healthcare payer/provider processes and the end-to-end claims lifecycle.
• Hands-on knowledge of claims adjudication, denials, appeals, prior authorization, and/or revenue
• Experience analyzing, optimizing, and transforming healthcare claims processes.
• Understanding of EDI 837/835 workflows and their role in claims submission and payment processes.
• Strong analytical and problem-solving capabilities, with the ability to identify root causes and

🎁 Benefits

• Full-time opportunity with a remote working arrangement in India.
• Opportunity to contribute to healthcare claims transformation and large-scale process optimization
• Exposure to RPA, AI/ML, intelligent automation, and process-mining technologies.
• Cross-functional collaboration with healthcare operations, IT, architecture, development, and
• Opportunity to influence operational efficiency through measurable improvements in claims
• Professional growth through involvement in strategic transformation, automation, and digital