Business Analyst – Healthcare Claims & HIPAA (Remote)
We are looking for an experienced Business Analyst with strong US Health Insurance domain expertise to support the implementation and enhancement of a Claims Management Platform while ensuring HIPAA compliance and regulatory alignment. ✅ Must-Have Skills: ✔ 10+ years of Business Analysis experience ✔ 8+ years in US Health Insurance Domain ✔ Strong experience with Enrollment, Eligibility, Prior Authorization, Claims, Payments & Denials ✔ Experience implementing Phase I & II of Claims Management Platforms ✔ HIPAA compliance and healthcare regulatory requirements ✔ BRDs, FRS, User Stories, Acceptance Criteria & Process Flows ✔ Stakeholder Management, Workshops & UAT Facilitation ✔ Agile/Scrum, Jira, Azure DevOps ✔ Data Governance, Data Quality & Audit Compliance ✔ Exposure to Microsoft Fabric ✔ Power BI Reporting & Analytics ✔ Vendor Integration, SFTP & Secure Data Exchange 🔹 Key Responsibilities:
- Gather, analyze, and document business requirements
- Translate business and regulatory requirements into functional specifications
- Facilitate stakeholder workshops and UAT sessions
- Define validation rules, governance requirements, and audit controls
- Collaborate with business, development, QA, and project teams
- Support reporting, analytics, and compliance initiatives