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Healthcare Claims Analyst

Healthcare Claims Analyst

Thryve Digital Health LLPHyderabad, Republic Of India, IN
13 days ago
Job description

Greetings from Thryve Digital !!

We are looking for a Business Analyst - US Healthcare (Claims) based in Chennai / Hyderabad.

Essential Responsibilities

  • Conduct thorough analysis of business processes to identify areas for improvement and optimization.
  • Collaborate with cross-functional teams to gather and document business requirements.
  • Assist in the development and implementation of new systems or enhancements to existing ones.
  • Analyze data trends, patterns, and insights to provide actionable recommendations.
  • Prepare and present reports, findings, and insights to stakeholders.
  • Work closely with project managers to ensure successful project delivery.
  • Support in creating and maintaining documentation related to business processes and requirements.

The experience we are looking to add to our team

Required

  • Any Bachelor Degree
  • Candidate must have worked in US healthcare with experience minimum of 4+ years, especially in claims application as business analyst or consultant
  • Membership and provider domain knowledge / experience is preferable, but must have claims knowledge
  • FEP, ITS (Interplan Teleprocessing system) / Blue card claims and B2 application knowledge / experience is preferable
  • Work experience in EHR / EMR is also considered, but must have worked or possess knowledge of claims submission to Payers
  • Should have knowledge in working with all types of claim – medical, hospital, Pharmacy, Dental, Vision, Blue card / ITS etc
  • Should have the fundamentals of requirement gathering, elicitation, documenting, and transition over to internal and external stakeholders
  • Should have experience in writing functional specification documents / BRD
  • Should have ability to solve the complex business problems and exposed to complete software development life cycle (SDLC)
  • Should have sound knowledge in claims testing end to end, work under minimal supervision and take complete ownership of delivery
  • Sound have knowledge of current US federal and state laws with regards to healthcare governance and policies, and preferable to have PAHM / FAHM certifications or working towards certification
  • Business Analysis knowledge is mandatory, and preferable to have certifications like CBA / CBAP or working towards certification
  • Nice to have work exposure with agile and scrum teams
  • Preferable to have basic SQL knowledge
  • Soft spoken, thrive to learn and willing to work in flexible timing, and may require to work on weekend as per business need
  • Location – Chennai / Hyderabad
  • About Thryve

    Thryve Digital Health LLP is an emerging global healthcare partner that delivers strategic innovation, expertise, and flexibility to its healthcare partners. Being a US healthcare conglomerate captive, we have direct access to deeper insights that help us accelerate our learning process and keeps us ahead of the curve. Thryve delivers next-generation solutions that enable our healthcare partners to provide positive experiences to their consumers. Our global collaborative of healthcare, operations, and IT experts creates innovative and sustainable processes for our clients, which keeps the ever-evolving consumers engaged and assists them in managing the future of their healthcare better. We recognize that our people are our strength and the diverse talents they bring to our global workforce are directly linked to our success. Thryve is an equal opportunity employer and places a high value on integrity, diversity, and inclusion in the organization. We do not discriminate on the basis of any protected attribute. For more information about the organization, please visit www.Thryvedigital.Com

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    Healthcare Analyst • Hyderabad, Republic Of India, IN

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