Senior Analyst US Healthcare Payer Domain

Job description

Must Have Technical/Functional Skills We are seeking a highly experienced Senior Analyst with strong expertise in the US Healthcare Payer domain. The candidate will play a critical role in analyzing payer-side business processes including claims, enrollment, membership, and benefits, while collaborating with business and technology teams to deliver scalable healthcare solutions. . Must-Have Technical / Functional Skills Domain Expertise

• Strong experience in US Healthcare Payer domain(8 years)
• Deep understanding of:
• Claims processing lifecycle
• Enrollment & Membership
• Benefits configuration
• Billing and provider interactions

Healthcare Data & Standards

• Knowledge of: o EDI Transactions (837, 835, 834) o HL7 (good to have) o FHIR standards (good to have)
• Understanding of HIPAA compliance requirements

Functional Expertise

• Strong experience in:
• Requirement gathering and documentation
• Business process analysis
• Agile methodologies (Scrum/SAFe)

Experience with tools

• o JIRA / Rally / ALM
• Basic SQL for data validation and analysis

Preferred Skills

• Exposure to Medicare, Medicaid, and Commercial plans
• Experience with:
• Provider & network management
• Care management workflows
• Claims adjudication and payment systems
• Experience collaborating with data, integration, and downstream systems Salary Range: $100,000- $140,000 a year TCS Employee Benefits Summary: Discretionary Annual Incentive.

Comprehensive Medical Coverage

Medical & Health, Dental & Vision, Disability Planning & Insurance, Pet Insurance Plans.

Family Support

Maternal & Parental Leaves.

Insurance Options

Auto & Home Insurance, Identity Theft Protection.

Convenience & Professional Growth

Commuter Benefits & Certification & amp; Training Reimbursement.

Time Off

Vacation, Time Off, Sick Leave & Holidays.

Legal & Financial Assistance

Legal Assistance, 401K Plan, Performance Bonus, College Fund, Student Loan Refinancing. #LI-SP1

Qualifications

BACHELOR OF COMPUTER SCIENCE