Job Description

This role is for one of the Weekday's clients

Salary range: Rs 1400000 - Rs 2500000 (ie INR 14-25 LPA)

Min Experience: 5 years

Location: Chennai, Hyderabad

JobType: full-time

Requirements

Responsibilities:

• The candidate must have at least 4 years of experience working in US healthcare, particularly in claims applications as a business analyst or consultant. Experience with FEP, ITS (Interplan Teleprocessing System)/Blue Card claims, and B2 applications is preferred.
  
• Experience in EHR/EMR is also acceptable, but the candidate should have worked with or possess knowledge of claims submission to payers.
  
• Must be knowledgeable in handling all types of claims, including medical, hospital, pharmacy, dental, vision, Blue Card/ITS, etc.
  
• Should have strong expertise in end-to-end claims testing, be capable of working with minimal supervision, and take full ownership of deliverables.
  
• Must possess a solid understanding of current US federal and state healthcare regulations and policies. Having PAHM/FAHM certifications or actively pursuing them is preferred.
  
• Basic knowledge of SQL is desirable.
  
• Business analysis skills are essential, and certifications such as CBA/CBAP or progress towards these certifications are preferred.
  
• Experience in drafting functional specification documents or business requirement documents (BRD) is required.
  
• Should be proficient in requirement gathering, elicitation, documentation, and transitioning information to both internal and external stakeholders.
  
• Ability to solve complex business problems and familiarity with the complete software development life cycle (SDLC) are necessary.
  
• Must be eager to learn, flexible with working hours, and willing to work on weekends if required by business needs.

Skills

business analyst

edi837

adjudication

US Healthcare

claims

payer