Lead Business Analyst with Medicare insurance domain

Synechron•Piscataway, NJ

20h•$115,000 - $125,000•Remote

About The Position

We are seeking an experienced Senior Business Analyst with strong expertise in the Medicare insurance domain. The ideal candidate will have a solid understanding of Life, Annuity, and Health insurance products and their sub-types. You will play a key role in analyzing business needs, documenting requirements, and supporting processes such as claims processing, claim adjudication, policy administration, new business, and underwriting to help us deliver efficient Medicare solutions.

Requirements

Bachelor’s or Master’s degree in Business, Healthcare, Insurance, or related fields.
Proven experience as a Business Analyst in the Medicare insurance domain or similar healthcare insurance sectors.
Good understanding of Life, Annuity, and Health insurance products and their sub-types.
Hands-on experience with claims processing, claim adjudication, policy management, underwriting, and new business processes.
Knowledge of Medicare regulations, policies, and compliance requirements.
Experience working with insurance management systems and core platforms.
Develop use cases, user stories, and functional specifications for system development.
Strong understanding of healthcare insurance processes, policies, and regulations (e.g., HIPAA).
Excellent analytical, problem-solving, and critical-thinking skills.
Proficiency in requirements gathering, process modeling, and documentation.
Experience with healthcare data analysis and reporting tools.
Familiarity with healthcare IT systems, Electronic Health Records (EHR), and insurance management software.
Strong interpersonal and communication skills to liaise with stakeholders at all levels.

Nice To Haves

Project management skills and familiarity with Agile/Scrum methodologies are advantageous.
Business Analysis certifications (CBAP, CCBA, or equivalent).
Experience with Agile/Scrum methodologies.
Proficiency in data analysis, reporting, and process modeling tools.
Strong stakeholder management and presentation skills.

Responsibilities

Gather, analyze, and document detailed business 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.

Benefits

A highly competitive compensation and benefits package.
A multinational organization with 60 offices in 20 countries and the possibility to work abroad.
10 days of paid annual leave (plus sick leave and national holidays).
Maternity & paternity leave plans.
A comprehensive insurance plan including medical, dental, vision, life insurance, and long-/short-term disability (plans vary by region).
Retirement savings plans.
A higher education certification policy.
Commuter benefits (varies by region).
Extensive training opportunities, focused on skills, substantive knowledge, and personal development.
On-demand Udemy for Business for all Synechron employees with free access to more than 5000 curated courses.
Coaching opportunities with experienced colleagues from our Financial Innovation Labs (FinLabs) and Center of Excellences (CoE) groups.
Cutting edge projects at the world’s leading tier-one banks, financial institutions and insurance firms.
A flat and approachable organization.
A truly diverse, fun-loving, and global work culture.