Business Analyst
- Compensation
- ₹1M–₹2M / yr
- Location
- Not listed
- Work setup
- Not specified
- Seniority
- Not specified
- Employment
- Not specified
- Experience
- 5+ years
- Category
- Business analysis
- Posted
Must have
- - Bachelors degree in business, Insurance, Computer Science, or a related field.
- - 5-10 years of proven experience as a Business Analyst in the Life and Health insurance industry, with a strong focus on claims processing and product underestanding.
- - Proficiency in claims rules, fraud analytics, and data analysis techniques.
- - Strong communication and interpersonal skills to effectively collaborate with stakeholders at all levels of the organization.
- - Ability to translate complex business requirements into clear and actionable technical specifications.
- - Proven track record of successfully delivering business analysis projects in the insurance domain.
- - Familiarity with Agile or other project management methodologies is a plus.
- - Certification in Business Analysis (e.g., CBAP) is desirable but not mandatory.
Full description
Description :Job Title : Business Analyst - Life and Health Insurance
Job Summary :
We are seeking a highly skilled and experienced Business Analyst with 7-10 years of focused experience in the life and health insurance industry, particularly in claims processing. Understanding the key KPIs that drive claims processing is critical. The candidate will play a crucial role in bridging the gap between business needs and IT solutions, contributing to the enhancement of our solution. The ideal candidate will have a strong techno-functional understanding of the insurance product benefits, coverages, claims rules, exclusions and fraud analytics and should know about Product Configuration in the system. Having a comprehensive grasp of Medical Codes ICD, PCS, and CPT codes would be an additional plus for this role.
Key Responsibilities :
- Collaborate with the Claims head, claims processing and provider management team to gather and analyse business requirements related to claims processing.
- Conduct in-depth analysis of the existing claims systems and processes, identifying areas for improvement and optimization.
- Previous experience in understanding and working with ICD, PCS, and CPT codes will be an advantage.
- Translate business requirements into clear and concise technical specifications for the IT development team.
- Understand and analyse the insurance product with respect to benefits, coverages, limits, exclusions etc to analyse the configuration of the product in the Product Configurator
- Create detailed documentation of business requirements, processes, and solutions.
- Develop and document business process models to illustrate current and future states
- Identify opportunities for process improvements and contribute to ongoing optimization efforts.
- Facilitate workshops and meetings with stakeholders to elicit and document requirements, ensuring all relevant information is captured accurately.
- Perform detailed data analysis to identify trends, patterns, and potential areas of concern related to claims processing and fraud detection.
- Develop and maintain comprehensive documentation, including functional requirements, use cases, process flows, and data mappings.
- Collaborate closely with tech teams throughout the development lifecycle to ensure proper implementation of business requirements.
- Assist in user acceptance testing (UAT) and provide support during the testing phase to validate that the solutions meet the business needs.
- Act as a subject matter expert (SME) on claims processing, offering insights, recommendations, and expertise to support decision-making processes