Senior Business Analyst

Product Development Job Roles Responsibilities

1. Be the Operational Truth Source for the Platform. You will be accountable for validating that platform outputs make sense in the real world. This includes:
- Reviewing payer contracts, amendments, and fee schedules
- Interpreting real-world contract logic (lesser-of, modifiers, MCO products, effective dates)
- Reading raw 835 remits and identifying: Reimbursement issues vs legitimate adjustments; Payer miss configuration vs provider error; Systemic vs one-off issues
- Calling out false positives and explaining why something is not a true issue. If something looks technically correct but operationally wrong, you are expected to stop it.

1. Own Synthetic Data Realism (Critical). The platform will initially rely on synthetic data for development and validation. You will:
- Define what realistic synthetic data looks like: payer mix, CARC/RARC distributions, modifier usage patterns, underpayment frequency and dollar impact
- Review synthetic data sets and flag unrealistic assumptions




- Guide engineers and vendors on correcting synthetic data generation logic. This role protects the credibility of everything we build.

1. Be Deeply Embedded in Testing Validation. You will be hands-on in:
- Reviewing detection outputs and classifying true vs false positives
- Validating confidence scores against operational reality
- Helping define suggested next step classifications (appeal, rebill, review, do not pursue)
- Testing against real customer data during pilot phases. Your feedback will directly shape detection logic, confidence thresholds, and future AI agent behavior. You are effectively the human-in-the-loop backbone of the system.

1. Act as the RCM Counterweight in Vendor Engagements. You will actively participate in vendor evaluations, technical reviews, and edge-case discussions. You will:
- Ask uncomfortable but necessary questions
- Spot hand-wavy answers around contracts or EDI
- Distinguish

📌 Senior Business Analyst (Pune)
🏢 Credence Resource Management
📍 Pune