Job Description – BA - Business Analyst – US Medicare – Claims Management System Job Summary: We are seeking a highly motivated and detail-oriented Business Analyst to join our team, focusing specifically on our US Medicare Claims L2 Software support project. The successful candidate will play a crucial role in bridging clients’ business needs, issue resolution, servicing the client requirement, ensuring our software effectively meets the evolving demands of the healthcare claims processing landscape. You will be responsible for gathering, analyzing, and documenting service requests and defect raised by the client. As a part of this role, you will be defining and documenting requirements, facilitating communication between stakeholders within and outside of the organization. Your role will remain critical point of contact with the clients. Responsibilities: • Requirements Gathering and Analysis: o Conduct thorough analysis of Service Request, Enhancement, Defects raised by the healthcare claims management clients. Translate business requirements, enhancement into clear and concise specifications for development and the quality assurance teams. o Document and manage detailed functional and non-functional requirements. o Effectively communicate with stakeholders, including developers, testers, product managers, and clients, to ensure alignment and understanding. o Prepare RCA(Root Cause Analysis), findings and recommendations to stakeholders in a clear and professional manner. o Ensure that the ticketing system is well updated o Collaborate with development, quality assurance and product management teams throughout the SDLC, from planning the resolution to implementation in the production systems. o Participate in sprint planning, reviews, and retrospectives. o Provide support for testing and user acceptance testing (UAT), provide demo to UAT teams and Client in the test environment. o Assist in the creation of test cases and ensure requirements traceability. o Ensure that the ticketing tool is up to the date from the documentation point of view and transactional parameters o Identify opportunities for process improvement and optimization within the US Medicare Claims Software and related workflows. o Analyze data and metrics to identify trends and areas for improvement. o Mentor junior Business Analyst • Healthcare Claims Expertise: o Develop and maintain a strong understanding of healthcare claims processing, including industry standards (e.g., HIPAA, ICD-10, CPT), regulations, and best practices o Experience with claims management software is a significant plus. o Stay up-to-date on industry trends and emerging technologies related to claims management. o Act as a subject matter expert on healthcare claims within the organization. Qualifications: • Bachelor's degree in Business Administration, Computer Science, Healthcare Administration, or a related field. • Certified in healthcare related certification such as AHM250 would be a plus • Minimum of 12 years of experience as a Business Analyst, preferably in the healthcare industry. • Strong understanding of healthcare claims processing and related workflows. • Proven experience in requirements gathering, analysis, and documentation. • Excellent communication, interpersonal, and presentation skills. • Strong analytical and problem-solving abilities. • Ability to work independently and as part of a team. • Familiarity with Agile software development methodologies • Knowledge of SQL, or database concepts is a plus.