Role description

Job Description - Analyst / Sr. Analyst

Process: Contracts & Booklets (US Healthcare - Payer)
Experience: 3+ Years
Shift: 5:30 PM - 2:30 AM IST (Night Shift)
Work Mode: 5 Days Work from Office
Location: India (Trivandrum /Chennai)
Joining: Immediate

Role Summary

We are looking for a Contracts & Booklets Analyst to support US Healthcare Payer operations in a BPO environment. The role focuses on creation, validation, and maintenance of member-facing benefit documents (Contracts & Booklets) aligned with benefit configuration and product setup. The candidate must have strong benefit interpretation skills and hands-on experience in payer-side configuration and documentation processes.

Key Responsibilities

1. Contract & Booklet Creation

- Create and maintain member contracts and booklet documents based on configured plans
- Develop document components such as:
- - Schedule of Benefits (Copay, Deductible, Coinsurance)
- Riders and benefit sections
- Preventive schedules and plan details

- Ensure documents meet client formatting, regulatory, and compliance standards

2. Benefit Configuration Alignment

- Interpret benefit designs from product configurator / payer systems
- Convert system configurations into accurate member-facing documents
- Validate cost share elements against configured benefits:
- - Copay / Coinsurance / Deductible / OOP

- Ensure alignment across configuration, schedule, and filing documents

3. Validation & Quality Assurance

- Perform QA validation of contracts and booklets before production release
- Conduct checks such as:
- - Schedule vs Product Config comparison
- Filing vs Template validation





- Maintain high accuracy and quality benchmarks

4. Workflow & Production Handling

- Manage end-to-end workflow:
- - Intake via ticketing system
- Template extraction and mapping
- Document creation and QA
- Final production release

- Handle volumes with SLA adherence and turnaround commitments

5. Collaboration & Stakeholder Coordination

- Work closely with:
- - Benefit Configuration teams
- QA and Testing teams
- Client stakeholders (onshore/offshore)

- Support testing, appeals, and audit queries with document references

6. Continuous Improvement

- Identify gaps in documentation and configuration mapping
- Support automation, standardization, and process efficiency initiatives
- Contribute to SOPs, QA checklists, and process documentation

Eligibility & Qualifications

Education

- Any Graduate (Mandatory)

Experience (Mandatory)

- 3+ years in US Healthcare Payer operations
- Mandatory experience in Benefit Configuration / Product Configuration
- Hands-on exposure to:
- - Contracts & Booklets
- Benefit documentation / Plan setup

Required Skills

Domain Skills

- Strong knowledge of:
- - Health plan benefits (Copay, Deductible, Coinsurance, OOP, Accumulators)
- Commercial / Medicare plan structures

- Understanding of:
- - Benefit configuration workflows




- Plan design & document mapping

Technical Skills

- Experience with payer tools like:
- - Product Configurator / Benefit Systems
- HighRoads / P2A / FOS (or similar platforms)

- Good working knowledge of:
- - MS Word (document editing & formatting)
- Excel (validation & mapping)

Behavioral Skills

- High attention to detail and accuracy
- Analytical thinking and problem-solving ability
- Strong written and verbal communication
- Ability to work in fast-paced production environment

Preferred Skills

- Experience in:
- - Contract & Booklet creation / audit
- Benefit testing / appeals support

- Exposure to payer platforms:
- - Facets / QNXT / HealthRules

- Knowledge of compliance and regulatory guidelines

Key Competencies

- Accuracy & Quality Focus
- Benefit Interpretation Expertise
- Stakeholder Communication
- SLA & Delivery Ownership
- Continuous Improvement Mindset

Skills

advantages administration,us healthcare,coinsurance,benefits configuration,qnxt,regulatory domain,

About UST
UST is a global digital transformation solutions provider. For more than 20 years, UST has worked side by side with the world’s best companies to make a real impact through transformation. Powered by technology, inspired by people and led by purpose, UST partners with their clients from design to operation. With deep domain expertise and a future-proof philosophy, UST embeds innovation and agility into their clients’ organizations. With over 30,000 employees in 30 countries, UST builds for boundless impact—touching billions of lives in the process.

📌 Associate II - BPM(Contract & Booklet) (Chennai)
🏢 UST
📍 Chennai