We are hiring an experienced Healthcare Business Analyst with strong expertise in the US Healthcare Payer domain, Claims Processing, Claims Adjudication, and Requirements Management.

Key Responsibilities

- Gather, analyze, and document business requirements from clients and stakeholders.

- Create BRDs, FRDs, User Stories, RTM, Process Flows, and Functional Specifications.

- Work closely with business users, SMEs, Development, QA, and Architecture teams.

- Analyze healthcare payer workflows including Claims, Enrollment, Eligibility, Provider, and Care Management.

- Conduct Gap Analysis and prepare AS-IS and TO-BE process documentation.

- Support UAT, defect triage, release validation, and production deployment activities.

- Facilitate requirement walkthroughs, sprint ceremonies, and stakeholder discussions.

- Perform SQL-based data validation and business analysis.

- Support healthcare product enhancements and implementations.

Mandatory Skills

- 7-10+ years of overall experience.





- Strong experience in US Healthcare Payer domain.

- Hands-on experience with Claims Processing & Claims Adjudication.

- Experience with Medicaid, Medicare, or Commercial Payer systems.

- Strong Requirement Gathering and Documentation skills.

- Experience creating BRD, FRD, RTM, User Stories, Acceptance Criteria.

- Experience with Member Enrollment, Eligibility, Provider or Care Management modules.

- Robust SQL skills for data validation and analysis.

- Experience working in Agile/Scrum environments.

- Excellent communication and stakeholder management skills.

Preferred Skills

- MMIS/MES implementation or modernization experience.

- Experience with Facets, QNXT, HealthEdge, HealthRules, HealthAxis, TriZetto, or similar payer platforms.

- Knowledge of EDI 837/835, HIPAA, HL7/FHIR.

- Experience with Jira, Confluence, Visio, Azure DevOps.

📌 Healthcare Business Analyst - Payer / Medicaid / Claims Adjudication (Bengaluru)
🏢 Conduent
📍 Bengaluru