We are Looking for a strong US Healthcare Claims SME who can also play the Business Analyst role
- Primary requirement: Deep Claims Adjudication expertise with 8–12+ years of relevant US Healthcare experience.
- Understand and challenge complex Claims business requirements
- Translate requirements into strong User Stories & Acceptance Criteria
- Identify business-rule gaps, dependencies and exception scenarios
- Guide Development & Testing teams throughout the sprint
- Understand end-to-end adjudication including Advantages, Pricing, Provider, COB, Member liability, Denials/Pends, Adjustments and Reprocessing
Preferred: Agile/Scrum exposure, SQL knowledge and experience with Facets or a similar payer core administration platform.
📌 US Healthcare Claims SME (Tamil Nadu)
🏢 Cognizant
📍 Tamil Nadu
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