Senior Analyst US Healthcare Payer Domain
Indexed description
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:
- Claims processing lifecycle
- Enrollment & Membership
- Benefits configuration
- Billing and provider interactions
- Knowledge of:
- EDI Transactions (837, 835, 834)
- HL7 (good to have)
- FHIR standards (good to have)
- Understanding of HIPAA compliance requirements
- Strong experience in:
- Requirement gathering and documentation
- Business process analysis
- Agile methodologies (Scrum/SAFe)
- Experience with tools:
- JIRA / Rally / ALM
- Basic SQL for data validation and analysis
- Exposure to Medicare, Medicaid, and Commercial plans
- Experience with:
- Provider & network management
- Care management workflows
- Claims adjudication and payment systems
- Experience collaborating with data, integration, and downstream systems
TCS Employee Benefits Summary
Discretionary Annual Incentive.
Comprehensive Medical Coverage: Medical & Health, Dental & Vision, Disability Planning & Insurance, Pet Insurance Plans.
Family Support: Maternal & Parental Leaves.
Insurance Options: Auto & Home Insurance, Identity Theft Protection.
Convenience & Professional Growth: Commuter Benefits & Certification & amp; Training Reimbursement.
Time Off: Vacation, Time Off, Sick Leave & Holidays.
Legal & Financial Assistance: Legal Assistance, 401K Plan, Performance Bonus, College Fund, Student Loan Refinancing.
Qualifications: BACHELOR OF COMPUTER SCIENCE
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