What are the responsibilities and job description for the Business Analyst Health Insurance (Agentic AI) position at Arbor Tek Systems?
Job Title: Business Analyst Health Insurance (Agentic IVR / Agentic AI)
Location: Boston, MA (Hybrid)
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.
Salary : $50 - $55