Senior Business Analyst – Claims Module (Claims Domain Lead) at ASOFT Consulting LLC | Torre
Senior Business Analyst – Claims Module (Claims Domain Lead)
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ASOFT Consulting LLC

Senior Business Analyst – Claims Module (Claims Domain Lead)

ASOFT Consulting LLC
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Full-time

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Remote (anywhere)
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 20 days ago

Responsibilities

We are looking for a Senior Business Analyst / Claims Domain Lead with strong Healthcare, Medicaid/Medicare, MMIS, Claims Processing & Adjudication experience.Key RequirementsStrong Healthcare domain experience with Medicaid & MedicareHands-on experience with Claims Processing & AdjudicationStrong understanding of Claims lifecycle and pricingExperience with MMIS projects and Claims modulesKnowledge of Benefits/Program configurationStrong understanding of Reference Codes/Data SetsAbility to perform SQL queries, data validation, system analysis & RCAExperience working with EDI X12 transactionsExperience with 837P/I/D, 835, 834, 270/271, 276/277Understanding of Professional, Dental, Institutional, Pharmacy, Encounters & Capitation claimsFamiliarity with Facets, CMdS, GHS or similar claims systemsExperience with Postman / Interface TestingAbility to work closely with Clients, Development, QA, Architecture & Design teamsExperience creating BRD/requirements, RTM, test scenarios and test plansExcellent communication and stakeholder management skillsClaims LifecycleMember → Provider → Claim Submission → Adjudication → Payment → ReportingPreferred8+ years of Healthcare experienceStrong MMIS Claims backgroundAbility to lead requirements and client discussionsExperience with demos, feedback tracking and implementation decisionsStrong analytical, troubleshooting and problem-solving skillsInterested candidates can share resumes at: nshivasai@asofttek.com
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