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Business Analyst - healthcare Payer CLM

Business Analyst - healthcare Payer CLM

Name: Jobpe
Address: T-Hub, Plot No 1/C, Sy No 83/1, Raidurgam panmaktha, Knowledge City Rd, Hyderabad, Telangana, 500081, IN
Telephone: +91-83339-09630
Price range: Free

Virtusa

8 - 13 years

6 - 10 Lacs

hyderabad

Posted:1 week ago| Platform:

Apply

Skills Required

business analysis qa data modeling cms edi contract lifecycle management qnxt

Work Mode

Work from Office

Job Type

Full Time

Job Description

Ability Gather, analyse, and document business and technical requirements for healthcare Programs

Experience on core business applications in Enrolment, Claims. Payment areas (Facets, QNXT , NASCO etc )

Knowledge of CMS rating standards (STAR) and quality measures reporting

Ability to Interpret and map HIPAA X12 EDI transaction sets (e.g., 270/271, 837, 835, 999) to system data models and ITX transformations.

Conduct gap analysis, impact analysis, and facilitate design walkthroughs with business and technical teams.

Collaborate with QA teams to define test scenarios, acceptance criteria, and assist in defect triage.

Coordinate across cross-functional teams (product, ops, compliance, providers) to ensure integration requirements are met.

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Business Analyst - healthcare Payer CLM