IT Business Analyst

1 day ago

Philippines 77soft Full time $60,000 - $80,000 per year

IT Business Analyst (API Integration, Healthcare System)Direct message the job poster from Seven SevenSEVEN SEVEN GLOBAL SERVICES IS LOOKING FOR AN IT BUSINESS ANALYST Work Setup: WFHWork Schedule: DayshiftRoles and Responsibilities:Analyze and document the business & operational needs for the health claims software solution, ensuring alignment with industry standards, regulatory guidelines, and client needs. Collaborate with stakeholders, including clients, software developers, product managers, and implementation managers, to define the scope, objectives, and deliverables of the product delivery to the customer.

Conduct detailed analysis of existing processes and workflows related to health claims processing, clinical coding, and benefits administration based on clients' as-is process and propose to-be process based on the products offering. Identify gaps in operations & industry practices and recommend solutions to optimize operational efficiency and accuracy with compliance to regulatory requirements. Develop and maintain comprehensive documentation, including user-needs, functionalities, user stories, and acceptance criteria scenarios.

Collaborate with the product manager and implementation lead to ensure that the product solution meets the defined requirements to deliver value to customers and solve their pain points. Conduct thorough analysis of business processes such as benefit definition, claim matching, etc., that involve clinical coding and workflows to build required capabilities from inception. Thorough understanding of the product offering and ability to localize it to new markets through defining localization features.

Ability to breakdown features into epics, stories, and tasks for development and groom the stories to meet the definition of ready as per agile best practices. Collaboration with business and systems architects on overall product implementation feasibility and standards. Conduct user acceptance testing to validate the functionality, usability, and performance of the software solution to meet the definition of done as per agile best practices and customer needs.

Stay up-to-date with industry trends, regulatory changes, and emerging technologies relevant to health claims processing and clinical coding. Post go-live operationalization support to clients to facilitate migration, initial setup & provide training. Knowledge and Experience:Minimum 5 years of experience with proven expertise in business and product analysis in the health insurance industry.

Familiar with Test-Driven Development (TDD) approach and Agile best practices. Subject matter expertise in claims processing and related areas such as clinical coding, health benefit codifications, alternative reimbursement models for provider pricing, etc. Familiar with claims and benefit data structure and related industry standard; HL7 FHIR data standard is preferred.

Previous SaaS experience is preferable. Seniority LevelMid-Senior levelEmployment TypeFull-timeJob FunctionInformation Technology

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