Role Description

Benefit Configuration Analyst The Benefit Configuration Analyst is responsible for supporting and managing healthcare payer business processes related to benefit administration, plan maintenance, enrollment, claims, and operational support activities. The role focuses on analyzing business requirements, executing operational processes, ensuring compliance with service level agreements (SLAs), and collaborating with stakeholders to deliver high-quality healthcare operations services.

Key Responsibilities Business Process Operations Execute healthcare payer operational processes related to benefits, enrollment, eligibility, membership, claims, and account maintenance. Support implementation of current business requirements, plan changes, renewals, and operational updates. Perform activities in healthcare administration platforms while ensuring accuracy and compliance with business guidelines.

Ensure timely completion of assigned work items in accordance with established SLAs and quality metrics.

Requirements Analysis &

- Process Support Review business documents, benefit summaries, operational requirements, and related healthcare documentation. Analyze business requirements and identify process impacts. Support process transitions, operational enhancements, and business change requests. Collaborate with upstream and downstream teams to ensure seamless process execution.

Quality

Assurance &
- Compliance Perform validation and quality checks on completed transactions and operational activities. Investigate and resolve process exceptions, operational issues, and escalations. Ensure adherence to regulatory, client-specific, and organizational compliance requirements. Maintain accurate documentation and audit-ready records.





Stakeholder Collaboration

Coordinate with business SMEs, client teams, operations partners, and leadership teams. Participate in stakeholder meetings, operational reviews, process discussions, and status updates. Provide operational support during implementations, renewals, and production activities. Communicate process updates, issues, and resolutions effectively to stakeholders.

Continuous Improvement

Identify opportunities to improve operational efficiency and quality. Support automation, AI, and process optimization initiatives. Contribute to standardization of operational procedures, documentation, and best practices. Participate in process improvement projects and transformation initiatives.

Required Qualifications Experience 2 to 8 years of experience in Healthcare Payer Operations, Business Process Management (BPM), or related healthcare operations functions.

Experience working with health insurance products and healthcare business processes. Exposure to healthcare administration platforms and operational workflows.

Skills Benefit Configuration is the primary skill Administration Healthcare Domain Knowledge Healthcare Payer Operations Health Insurance Products Enrollment &

- Membership Claims Processing Provider Network Management Commercial, ACA, Medicare, and Medicaid Products Business &




- Operational Skills Business Process Management (BPM) Process Analysis and Improvement Operational Excellence Quality Assurance Root Cause Analysis Documentation and Reporting Technical Skills Microsoft Excel and Reporting Tools Data Analysis and Reporting SQL (Preferred) Healthcare Administration Systems Soft Skills Strong analytical and problem-solving skills. Excellent verbal and written communication. Ability to collaborate with cross-functional teams and stakeholders. Strong attention to detail and commitment to quality. Ability to manage multiple priorities in a fast-paced environment.

Working Conditions Should be willing to work from the office (up to 5 days a week, if required). Should be flexible to work until 9:00 PM IST based on business requirements. Must be willing to attend stakeholder meetings, client discussions, team meetings, and operational review sessions. Ability to support critical business deliverables and project deadlines as needed.

Preferred Qualifications Experience in healthcare payer operations within a BPM/shared services environment. Exposure to process improvement methodologies (Lean, Six Sigma, Continuous Improvement).

Experience supporting automation and digital transformation initiatives. Knowledge of healthcare compliance and regulatory requirements.

Designation: Specialist I / Specialist II - BPM (based on experience) Domain: Healthcare Payer Operations Function: Business Process Management (BPM) Experience: 2 to 8 Years Location: Hybrid / Work from Office (as per business requirement)

Skills

Claims Management, Microsoft Excel, Business Process Management, Healthcare Compliance Management

📌 Associate II - BPM (Kochi)
🏢 UST
📍 Kochi