Claims Business Analyst

Required
Bachelors or Masters degree in Information Technology or related field or 6 years of related and progressive experience in lieu
Candidate must have worked in US healthcare with experience minimum of 4 years, especially in claims application as business analyst or consultant
FEP, ITS (Interplan Teleprocessing system)/Blue card claims and B2 application knowledge/experience is preferable
Work experience in EHR/EMR is also considered, but must have worked or possess knowledge of claims submission to Payers
Should have knowledge in working with all types of claim medical, hospital, Pharmacy, Dental, Vision, Blue card/ITS etc.
Should have sound knowledge in claims testing end to end, work under minimal supervision and take complete ownership of delivery
Sound knowledge of current US federal and state laws with regards to healthcare governance and policies, and preferable to have PAHM/FAHM certifications or working towards certification
Preferable to have basic SQL knowledge
Business Analysis knowledge is mandatory, and preferable to have certifications like CBA/CBAP or working towards certification
Should have experience in writing functional specification documents/BRD
Should have the fundamentals of requirement gathering, elicitation, documenting, and transition over to internal and external stakeholders
Should have ability to solve the complex business problems and exposed to complete software development life cycle (SDLC)
Enthusiastic to learn and willing to work in flexible timing, and may require to work on weekend as per business need

Good to have
Experience in delivery management for US Healthcare Payer customers
Agile delivery methodology Nice to have work exposure with agile and scrum teams
Membership and provider domain knowledge experience is preferable

About Virtusa

Teamwork, quality of life, professional and personal development: values that Virtusa is proud to embody. When you join us, you join a team of 30,000+ people globally that cares about your growth — one that seeks to provide you with exciting projects, opportunities and work with state of the art technologies throughout your career with us.

Great minds, great potential: it all comes together at Virtusa. We value collaboration and the team environment of our company, and seek to provide great minds with a dynamic place to nurture new ideas and foster excellence.

Virtusa was founded on principles of equal opportunity for all, and so does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment is decided on the basis of qualifications, merit, and business need.