What are the responsibilities and job description for the Senior Healthcare Payer Analyst position at Health Here?
The role requires a Senior Analyst with extensive expertise in the US Healthcare Payer domain. Key responsibilities include
- Analyzing payer-side business processes such as claims, enrollment, membership, and benefits
- Collaborating with business and technology teams to deliver scalable healthcare solutions
- Gathering requirements and conducting business process analysis
- Applying Agile methodologies (Scrum/SAFe) and using tools like JIRA, Rally, or ALM
- Performing data validation with basic SQL and understanding healthcare data standards
- 8 years of domain experience in US Healthcare Payer
- Knowledge of claims processing, enrollment, benefits, billing, and provider interactions
- Familiarity with EDI transactions (837, 835, 834), HIPAA compliance, and healthcare standards like HL7 and FHIR
- Preferred experience with Medicare, Medicaid, commercial plans, provider & network management, and claims adjudication systems
- Strong analytical, documentation, and collaboration skills