Claims/Data Specialist BA/QA - Healthcare EDIExperience - 5 10+ YearsSummaryBA/QA qualified bridging business and technology for healthcare claims and EDI integrations - ensuring accuracy, compliance, and data integrity across payer operations.________________________________________Responsibilities- BA - Requirements elicitation, user stories, process mapping, gap analysis, UAT; support Agile ceremonies- Claims - End-to-end lifecycle - Intake, Adjudication, COB, Pricing, Payment, Appeals- EDI - 837P/I/D, 835, 277, 999, TA1, 270/271, 276/277, 278, 834- QA/Testing - Functional, Integration, E2E, Data Validation, Regression, UAT- Data - SQL-based profiling, reconciliation, root cause analysis across claims systems and EDI gateways- Defects - Log, triage,



manage through closure; support release readiness and production validation________________________________________Required Skills Domain - U.S. Payer ops, Claims adjudication, HIPAA EDI, ICD-10, CPT, HCPCS, DRGTechnical - Advanced SQL, EDI parsing, API testing (Postman/SoapUI), JSON/XML, Data mappingTools - JIRA Azure DevOps, qTest, SQL Server, Snowflake, Databricks, Power BI________________________________________Preferred: Facets, QNXT, HealthRules, Edifecs, TriZetto, FHIR/HL7, ISTQB/CBAP/CSMSuccess Metrics - Fewer claim defects, Higher EDI acceptance, Better data quality, Faster releasesAdditional Information -- The candidate should have minimum 5 years of experience in Business Process Analysis.- This position is based at our Hyderabad office.- A 15 years full time education is required.

📌 Business Analyst (India)
🏢 TRIGENT SOFTWARE PRIVATE
📍 India