Job Seekers, Please send resumes to resumes@hireitpeople.com

Detailed Job Description:

• Skill Set: Work closely with internal and external stakeholders to elicit business requirements
• Analyze business requirements and develops functional design specifications that include business rules, data mapping tables, logical flow charts, edit logic, etc.
• Usage of industry tools for requirement gathering, business processing modelling, defect/ CR/ Document Control tools
• Mandatory Skills Working knowledge of Claims processing, membership in US healthcare.
• Exposure to writing, understanding SQL Queries.
• Planning and Co-ordination skills.
• Exposure to Agile Methodologies and to tools like JIRA.
• Facilitate Scrum events such as backlog creation/grooming, prioritization, stand up meetings, estimation, showcase and retrospectives.
• Participate and/or Lead scrum adoption practices across the organization.
• Facilitate the documentation of working agreement, definition of ready and definition of done for the scrum team.
• Work with the scrum teams to improve metrics as necessary.
• Expertise in Claims Processing in HMO/PPO/POS and Medicaid/Medicare.
• Strong understanding of FACETS and Facets Data Modelling.
• Working experience of 5+ years in health insurance industry Good understanding of health insurance macro business functions and processes. Working knowledge of writing user stories, EPICS, Features.
• Experience with Informatica-Power Center.

Minimum years of experience*: 5-8 years

Certifications Needed: No

Top responsibilities you would expect the Subcon to shoulder and execute*:

• Healthcare BA role with Payor experience.
• Working knowledge of healthcare data Working knowledge of writing user stories, EPICS, Features