Job Description - Analyst / Sr. Analyst

Process: Product Config (US Healthcare - Payer)
Experience: 5+ Years (Mandatory)
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 Product Config Analyst to support US Healthcare 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 Product Setup documents designs
- 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
- Solid 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

Disclaimer: This job posting has been aggregated from external source. Role details, content, and availability are subject to change. Applicants are advised to confirm the latest information directly on the company website before applying.

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