Business Analyst – Medical Insurance Product

Job Summary

We are looking for an experienced Business Analyst with strong Medical Insurance domain expertise to work closely with the Product Owner, business stakeholders, technology teams, TPAs, healthcare providers, and external partners to deliver and enhance medical insurance products and digital solutions.

The ideal candidate should have a strong understanding of the end-to-end medical insurance lifecycle, including policy administration, member management, underwriting, endorsements, eligibility, benefits, pre-authorization, claims, provider management, billing, and integrations.

This role requires someone who can translate complex medical insurance business requirements into clear, actionable functional requirements for technology teams and actively support the product throughout its lifecycle.

Key Responsibilities

1. Medical Insurance Business Analysis

- Analyze and understand end-to-end medical insurance processes including policy, member, underwriting, benefits, eligibility, pre-authorization, claims, reimbursement, and provider management.
- Identify business gaps, process improvements, and product enhancement opportunities.

1. Requirements & Functional Specifications

- Gather and analyze requirements from Product Owners, clients, and business stakeholders.
- Prepare BRDs/FRDs, user stories, business rules, process flows, acceptance criteria, and functional specifications.
- Ensure requirements are clear, complete, and testable.

1. Product & Solution Analysis

- Work closely with the Product Owner, architects, developers, QA, and integration teams to translate business requirements into practical product solutions.
- Perform impact analysis across policy, claims, member, billing, provider, and integration modules.

1. Stakeholder & Delivery Support





- Act as the functional bridge between client/business stakeholders and technology teams.
- Participate in requirement workshops, backlog refinement, sprint planning, demos, and requirement clarifications.
- Support prioritization and resolution of functional issues during delivery.

1. Testing, UAT & Production Support

- Define business scenarios and support QA/UAT activities.
- Validate delivered functionality against business requirements and acceptance criteria.
- Support defect analysis, production issue resolution, and post-production validation.

Required Experience & Skills

Essential

- 5+ years of Business Analysis experience in the Medical Insurance / Health Insurance domain.
- Strong hands-on experience with medical insurance products and processes.
- Strong Medical Insurance domain experience across policy administration, member enrollment, endorsements, eligibility, benefits, underwriting, premium calculation, claims, reimbursement, pre-authorization, and provider management.
- Hands-on experience with enterprise insurance applications, including TPA and healthcare/provider integrations.
- Strong requirements analysis and documentation skills, including BRDs/FRDs, functional specifications, user stories, business rules, and acceptance criteria.
- Experience working in Agile/Scrum environments, collaborating with Product Owners, development, QA, and business stakeholders throughout the delivery lifecycle.
- Robust analytical, problem-solving, communication, and stakeholder management skills, with the ability to translate complex business requirements into practical system solutions.

Preferred

- Experience working with TPAs, hospitals, healthcare providers, PBMs, aggregators, and medical insurance APIs/integrations.
- Knowledge of FHIR/HL7, GCC medical insurance regulations, and digital health/insurance platforms.
- Exposure to claims automation, AI/digital transformation

📌 Business Analyst - Medical Insurance (Chennai)
🏢 Anoud Technologies
📍 Chennai