Job Summary

Contribute as a business analyst with four to five years of experience in the healthcare payer and provider space focusing on benefits open enrollment and HIPAA compliant processes for a hybrid work model in night shifts that supports accurate requirements smooth plan enrollments and compliant data handling for clients and members.

Responsibilities

• Collaborate with cross functional healthcare teams to gather business needs for perks open enrollment and convert them into clear and testable requirement specifications that guide downstream technical work and process design.
• Analyze complex payer and provider workflows related to enrollment eligibility billing and claims to identify gaps inefficiencies and compliance risks that could impact operational accuracy and member satisfaction.
• Document detailed current state and future state process flows for open enrollment scenarios including eligibility updates plan changes and special enrollment events to support consistent execution across business units.




• Develop comprehensive user stories use cases and acceptance criteria that reflect payer and provider rules for benefits enrollment ensuring that every scenario aligns with HIPAA compliant handling of member data.
• Coordinate with product owners configuration specialists and quality analysts to prioritize enrollment related requirements and ensure timely delivery that aligns with night shift release schedules and hybrid collaboration norms.
• Perform deep dive analysis on enrollment files and transactions to resolve data discrepancies such as missing coverage details incorrect effective dates and plan mapping errors that affect payer and provider partners.
• Validate that system configurations benefit plans and enrollment rules support accurate premium calculations coverage periods and member communications across multiple payer and provider lines of business.
• Support user acceptance testing for enrollment and eligibility functions by creating

📌 Business Analyst (Pune)
🏢 Cognizant
📍 Pune