Business Analyst || Healthcare Insurance

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Location

Experience

Job Summary

The Business Analyst (BA) in this role acts as the bridge between business stakeholders (claims, operations, providers, underwriters, etc.) and technical teams. The BA is responsible for eliciting, analyzing, and documenting business requirements, defining processes, driving solution design, ensuring alignment with domain regulations, and validating delivery. The person will work in a cross-functional environment and must have solid domain understanding of healthcare / insurance workflows (claims, eligibility, provider networks, reimbursements, benefits, etc.).

Key Responsibilities

• Engage with business stakeholders (claims, underwriting, provider network, operations, finance, compliance) to elicit and understand business needs and challenges
  
• Translate business requirements into clear, structured functional specifications, use cases, user stories, process flows, business rules, data definitions
  
• Model As-Is and To-Be” processes and identify gaps, improvement opportunities, and impacts
  
• Work with architecture / technical teams to design solutions, integrations, interfaces, APIs, data flows
  
• Validate that proposed solutions meet business needs, through reviews, walkthroughs, prototyping, proof-of-concepts
  
• Support system implementation: assist in development, help resolve clarifications, approve design, support test scenarios, user acceptance testing (UAT)
  
• Coordinate with QA / testing teams to ensure requirements coverage, manage defects / issues
  
• Analyze data—run reports, dashboards, and ad hoc queries—to validate outcomes, measure KPIs, detect deviations
  
• Facilitate change management: drive stakeholder buy-in, training, process adoption
  
• Ensure compliance with regulatory requirements (e.g. health insurance rules, regulatory bodies) and internal policies
  
• Prepare and present reports, presentations, status updates to senior management
  
• Provide input on roadmap, recommending enhancements, and feasibility assessments
  
• Mentor junior BAs / analysts (if applicable)