This role is for one of Weekday’s clients
Min Experience: 5+ years
Location: Remote India
JobType: full-time

We are looking for a Claims Business Analyst with 5+ years of experience in healthcare claims operations, business analysis, and process transformation. The ideal candidate will have solid knowledge of payer/provider claims processes and experience identifying opportunities for process optimization, automation, and digital transformation.

Requirements

Key Responsibilities:
- Partner with healthcare operations and IT stakeholders to assess current-state claims processes and define transformation roadmaps.
- Analyze end-to-end claims lifecycle, including eligibility verification, claims submission, adjudication, remittance, payment posting, denials, and appeals.
- Work with EDI 837/835 workflows and identify process gaps, manual interventions, rework, and delays.
- Analyze root causes of claim denials, inaccuracies, and operational inefficiencies.
- Identify opportunities for process standardization, optimization, RPA, and AI/ML-based automation.




- Leverage process intelligence and task/process mining tools such as UiPath, Celonis, or equivalent.
- Define and track business KPIs such as cycle time, accuracy, denial rate, productivity, and operational efficiency.
- Develop business cases, ROI models, and high-level process/solution concepts for automation initiatives.
- Partner with architects, developers, and RPA teams to translate business requirements into effective technology solutions.
- Support automation initiatives through discovery, process design, UAT, and hypercare from a functional perspective.
- Conduct workshops with claims operations, billing/coding, payer relations, and other business stakeholders.
- Present analysis, recommendations, and transformation strategies to senior stakeholders.
- Support change management, communication, and transition activities.

Required Skills:
- 5+ years of experience in healthcare claims, healthcare operations

📌 Claims Business Analyst (India)
🏢 Weekday AI
📍 India