U.S. Healthcare Payer Functional AnalystLocation: Bengaluru, In-office (Koramangala)Type: Full-timeExperience: 3+ yearsDomain: U.S. Healthcare PayerAbout the RoleKronosX AI Labs is looking for a U.S. Healthcare Payer Functional Analyst with solid functional knowledge of health plan operations and payer systems.You will work closely with Product, Engineering, and AI teams to translate real-world payer requirements into business rules, functional scenarios, workflows, and test cases.This role requires hands-on U.S. healthcare payer experience. Provider-side Revenue Cycle Management (RCM) experience will not qualify.What You'll Work OnYou’ll help define and validate real-world payer scenarios across member enrollment, eligibility, benefits, claims, claims adjudication, prior authorization, etc. You’ll analyze business requirements and healthcare data, define expected outcomes, identify functional gaps and edge cases, and validate that our platform behaves correctly from a health plan’s perspective.Must-Have QualificationsMinimum 3 years of U.S. healthcare experienceStrong hands-on experience specifically in the U.S. healthcare payer domainStrong functional knowledge of members, enrollment, eligibility, benefits, claims,



and claims adjudicationExperience translating business requirements into functional requirements, scenarios, business rules, or test casesAbility to understand healthcare data and validate it against payer business rulesStrong analytical, problem-solving, and communication skillsPreferred QualificationsKnowledge of X12 transactions such as 834, 270/271, 837, 835, and 278Experience with payer platforms, claims processing, benefit configuration, or adjudication systemsSQL knowledge for healthcare data analysis and validationExperience as a Payer Business Analyst, Functional Analyst or Functional ConsultantExperience working directly with U.S. health plans or payer technology teamsWho We're Looking ForWe’re looking for someone who understands how a health plan actually works, not just healthcare terminology.You should be able to take a scenario involving a member, eligibility, benefits, accumulators, providers, and claims and reason through how the claim should adjudicate and why.How to ApplySend to your CV to '[email protected]' and also include yourCVLinkedIn linkA brief note on your payer experienceSubject: [Your Name] - #PAYER

📌 U.S. Healthcare Payer Functional Analyst (Bengaluru)
🏢 KronosX AI
📍 Bengaluru