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Senior Analyst US Healthcare Payer Domain
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Tata Consultancy Services Limited
Mason, OH (In Person)
$120,000 Salary, Full-Time
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Job Description
Must Have Technical/Functional Skills We are seeking a highly experienced Senior Analyst with strong expertise in the US Healthcare Payer domain. The candidate will play a critical role in analyzing payer-side business processes including claims, enrollment, membership, and benefits, while collaborating with business and technology teams to deliver scalable healthcare solutions. . Must-Have Technical / Functional Skills Domain Expertise
- Strong experience in US Healthcare Payer domain(8 years)
- Deep understanding of: o Claims processing lifecycle o Enrollment & Membership o Benefits configuration o Billing and provider interactions Healthcare Data & Standards
Knowledge of:
o EDI Transactions (837, 835, 834) o HL7 (good to have) o FHIR standards (good to have)- Understanding of HIPAA compliance requirements Functional Expertise
- Strong experience in: o Requirement gathering and documentation o Business process analysis o Agile methodologies (Scrum/SAFe)
- Experience with tools: o JIRA / Rally / ALM
- Basic SQL for data validation and analysis Preferred Skills
- Exposure to Medicare, Medicaid, and Commercial plans
- Experience with: o Provider & network management o Care management workflows o Claims adjudication and payment systems
- Experience collaborating with data, integration, and downstream systems