Business Analyst
Indexed description
Job Title : Business Analyst – Health Insurance (Agentic IVR / Agentic AI)
Location : Boston, MA
Role Type: Contract
Key Responsibilities
Business & Domain Analysis
Elicit, analyze, and document business requirements for Agentic IVR and conversational AI use cases in US Health Insurance.
Understand and map payer workflows including Claims, Eligibility, Benefits, Referrals & Prior Authorization, ID Card, Enrollment, Billing, Pharmacy, and Cost Responsibility.
Translate business rules, decision logic, and exception handling into agentic conversational flows and IVR call journeys.
Partner with Client business SMEs to define success metrics, containment goals, and CX outcomes for IVR and virtual agents.
Ensure all requirements align with HIPAA, PHI/PII masking, and payer regulatory needs.
Required Qualifications
5+ years of Business Analyst experience in US Health Insurance domain with excellent communication skills
Strong understanding of payer operations: Claims, Eligibility, Benefits, Auth, Enrollment, Member Services.
Hands-on experience supporting IVR, Contact Center, or Conversational AI initiatives.
Experience or understanding of HIPAA, PHI/PII masking, auditability, and payer regulatory needs.
Solid experience with requirements documentation (BRD, FRD, User Stories, Acceptance Criteria).
Practical experience with Jira and Confluence, as well as an understanding of Agile methodologies
Familiarity with UAT, Pre-UAT, and Go-Live support in complex enterprise programs.
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