Business Analyst

Job summary

We are seeking an experienced Business Analyst to act as a subject matter expert (SME) for business systems and processes within the US Healthcare domain. The role involves driving business analysis, requirement gathering, and process optimization across claims processing, benefit configuration, and PBM systems.

The candidate will collaborate with cross-functional teams to define requirements, perform impact analysis, support implementations, and ensure regulatory compliance. This role also includes system testing, stakeholder management, and continuous improvement initiatives to enhance operational efficiency and client satisfaction.

Key Responsibilities

Act as a subject matter expert (SME) for business systems and healthcare processes

Gather, analyze, and document business and functional requirements

Perform impact analysis for system enhancements and changes

Work on Claims Processing / Adjudication and Benefit Configuration

Support PBM (Pharmacy Benefit Management) related workflows and systems

Collaborate with stakeholders across business, product, and technology teams

Drive process improvement and workflow optimization initiatives

Conduct root cause analysis and provide resolution strategies

Ensure adherence to regulatory and compliance standards

Prepare documentation including BRDs, FRDs, SOPs, and training materials

Facilitate client interactions, workshops, and presentations

Support production issues and provide ongoing system enhancements

Mandatory Skills

• Strong expertise in Business Analysis & Requirement Gathering

• Experience in US Healthcare Domain

• Hands -on experience in:

• Claims Processing / Adjudication

• Benefit Configuration

• PBM (Pharmacy Benefit Management)

• Strong Communication

• Process Improvement & Workflow Optimization

• Root Cause Analysis & Problem Solving

• Stakeholder & Client Management

• Regulatory Compliance & Audit Support

• Strong communication and presentation skills

• Proficiency in Microsoft tools: Excel , Word, Power Point, Visio, Project

Qualifications

• Bachelor's degree in business administration , Information Technology, or related

field

• 5+ years of experience in:

• Claims Processing / Adjudication

• Benefit Configuration

• PBM (Pharmacy Benefit Management)

Work Timings:

2 PM to 11 PM ( Provide 2-way Cab facility )

Regards,

Naveen V

[Confidential Information]