Lead Medicare & MedSupp Business Analyst

Accord Technologies Inc; Piscataway Township (NJ); Sur place; USD 120 000 - 150 000; Plein temps

Résumé du poste

Accord Technologies Inc. seeks a Lead/Senior Business Analyst with Medicare insurance domain expertise (Medicare Supplement).

You will analyze business needs, document requirements, and support claims processing, policy administration, underwriting, and new business initiatives to deliver compliant Medicare solutions. You will collaborate with claims, underwriters, and policy admins to translate requirements into functional specs, workflows, and test plans, ensuring adherence to HIPAA and

Qualifications

• Proven BA experience in Medicare insurance domain.
• Experience with Claims processing, underwriting, and policy management.
• Knowledge of Medicare regulations and HIPAA compliance.
• Experience with healthcare data analysis and reporting tools.
• Experience with insurance management systems and core platforms.
• Strong communication and stakeholder engagement skills.
• Familiar with Agile/Scrum methodologies.

Responsabilités

• Gather, analyze, and document requirements for Medicare, Life, Annuity, and Health insurance products and their sub-types.
• Understand and map core processes including claims processing, claim adjudication, policy administration, new business setup, and underwriting workflows.
• Collaborate with stakeholders like claims teams, underwriters, policy administrators, and compliance officers to ensure business needs are met.
• Translate business requirements into clear, detailed functional specifications, workflows, and use cases.
• Identify opportunities to improve processes, workflows, and systems for better efficiency and compliance.
• Support the design, testing, and implementation of new or enhanced systems and processes.
• Ensure all solutions adhere to Medicare regulations, industry standards, and best practices.
• Act as a liaison between technical teams and business units, facilitating effective communication.
• Provide expertise on claim workflows, policy lifecycle management, underwriting, and product features.
• Assist in User Acceptance Testing (UAT), stakeholder training, and rollout activities.
• Keep up-to-date with industry trends, regulatory changes, and best practices in Medicare and insurance domains.
• Collect and analyze business requirements from stakeholders, including healthcare providers, insurance companies, and regulatory bodies.
• Identify areas for operational efficiency and recommend improvements in healthcare insurance processes.
• Analyze healthcare and insurance data to identify trends, risks, and opportunities for cost savings and quality enhancement.
• Create detailed documentation such as business requirements, functional specifications, and process flows.
• Ensure that insurance processes comply with healthcare regulations and standards such as HIPAA.
• Act as a liaison between technical teams, management, and external stakeholders.
• Assess the effectiveness of new insurance products, systems, and processes.
• Support project planning, execution, and monitoring activities related to healthcare insurance projects.
• Assist in the integration of new healthcare insurance systems and technologies.

Connaissances

Business analysis

Medicare knowledge

Requirements gathering

Process modeling

Documentation

Stakeholder communication

Agile/Scrum

Problem solving

Data analysis

HIPAA knowledge

Project management

Formation

Bachelor's or Master's degree in Business, Healthcare, Insurance

Outils

EHR systems

Insurance management systems

Core platforms

Reporting tools

Description du poste

Accord Technologies Inc. seeks a Lead/Senior Business Analyst with Medicare insurance domain expertise (Medicare Supplement).

You will analyze business needs, document requirements, and support claims processing, policy administration, underwriting, and new business initiatives to deliver compliant Medicare solutions. You will collaborate with claims, underwriters, and policy admins to translate requirements into functional specs, workflows, and test plans, ensuring adherence to HIPAA and