Associate II - BPM

Job Summary

Benefit Configuration Analyst The Benefit Configuration Analyst is responsible for supporting and managing healthcare payer business processes related to benefit administration, plan maintenance, enrollment, claims, and operational support activities. The role focuses on analyzing business requirements, executing operational processes, ensuring compliance with service level agreements (SLAs), and collaborating with stakeholders to deliver high-quality healthcare operations services.

Responsibilities

• Execute healthcare payer operational processes related to benefits, enrollment, eligibility, membership, claims, and account maintenance.
• Support implementation of new business requirements, plan changes, renewals, and operational updates.
• Perform activities in healthcare administration platforms while ensuring accuracy and compliance with business guidelines.
• Ensure timely completion of assigned work items in accordance with established SLAs and quality metrics.
• Review business documents, benefit summaries, operational requirements, and related healthcare documentation.
• Analyze business requirements and identify process impacts.
• Support process transitions, operational enhancements, and business change requests.
• Collaborate with upstream and downstream teams to ensure seamless process execution.
• Perform validation and quality checks on completed transactions and operational activities.
• Investigate and resolve process exceptions, operational issues, and escalations.
• Ensure adherence to regulatory, client-specific, and organizational compliance requirements.
• Maintain accurate documentation and audit-ready records.
• Coordinate with business SMEs, client teams, operations partners, and leadership teams.
• Participate in stakeholder meetings, operational reviews, process discussions, and status updates.
• Provide operational support during implementations, renewals, and production activities.
• Communicate process updates, issues, and resolutions effectively to stakeholders.
• Identify opportunities to improve operational efficiency and quality.
• Support automation, AI, and process optimization initiatives.
• Contribute to standardization of operational procedures, documentation, and best practices.
• Participate in process improvement projects and transformation initiatives.

Required Qualifications / Experience

• Experience 2 to 8 years of experience in Healthcare Payer Operations, Business Process Management (BPM), or related healthcare operations functions.
• Experience working with health insurance products and healthcare business processes.
• Exposure to healthcare administration platforms and operational workflows.

Skills

• Benefit Configuration
• Healthcare Payer Operations
• Health Insurance Products
• Enrollment
• Membership
• Claims Processing
• Provider Network Management
• Business Process Management (BPM)
• SQL (Preferred)

Working Conditions

• Should be willing to work from the office (up to 5 days a week, if required).
• Should be flexible to work until 9:00 PM IST based on business requirements.
• Must be willing to attend stakeholder meetings, client discussions, team meetings, and operational review sessions.
• Ability to support critical business deliverables and project deadlines as needed.
• Location: Hybrid / Work from Office (as per business requirement).

Role Details

• Designation: Specialist I / Specialist II - BPM (based on experience)
• Domain: Healthcare Payer Operations
• Function: Business Process Management (BPM)
• Experience: 2 to 8 Years
• Location: Hybrid / Work from Office (as per business requirement)

Disclaimer: This job posting has been aggregated from external source. Role details, content, and availability are subject to change. Applicants are advised to confirm the latest information directly on the company website before applying.