Sr Healthcare BA - I_Healthcare Business Analysis/Consulting

Job Summary


Responsibilities

• Translate business needs into structured documentation, support product increments, ensure compliance with HIPAA/CMS/NSA guidelines, and work with stakeholders to drive adoption of recommended changes.
• Serve as SME for following (One or more) - Scheduling/Registration, Eligibility Benefits, Authorization (278), Coding/CDI, Claim Edits, Payment Posting, Denials Appeals, Underpayment management, AR follow-up, and Revenue Integrity.
• Define and monitor RCM KPIs.
• Interpret and apply payer policies, LCD/NCD guidelines, NCCI edits, and E/M coding standards, business analysis and requirements management.
• Produce structured deliverables including BRDs, FSDs, user stories, acceptance criteria, traceability matrices, UAT plans, RACIs, SOPs, and training materials.
• Support end-to-end requirements traceability and ensure alignment between business and technical teams.
• Contribute to product visioning, roadmap development, and release planning.
• Prioritize and refine backlogs in Jira/ADO based on business value and dependencies and work with engineering, QA, and data/AI teams to ensure solution clarity and feasibility.

Experience

• 8 - 10 Years

Location

• Mumbai

Educational Qualifications

• Engineering Degree - BE/ME/BTech/MTech/BSc/MSc.
• Technical certification in multiple technologies is desirable.

Skills

Mandatory Technical Skills

• Must have worked on at least one EHR product (Epic / Cerner / Allscripts / e-clinical works/McKesson) and Electronic Data Interchange (EDI) data sets
• Able to derive high impact use cases with good understanding of digital technologies (AI/ML/Analytics/Gen AI/ Automation) and industry trends
• Help Clients innovate and grow with potential opportunity savings identified
• Assess the impact of regulatory changes like pricing transparency on overall RCM processes
• Identify opportunities for process optimization, areas of improvement and efficiency improvements within the systems
• Excellent communication and interpersonal skills for effective collaboration with clients
• Demonstrate problem-solving abilities and strategic thinking to drive continuous improvement in client system and applications
• Should have innovative skills to adapt and create solution as per customer requirement, and create service offerings/solutions in identified areas
• Track latest developments in domain, competitors and healthcare technology developments.
• Lead one or more accounts and consulting teams to ensure Customer Success, in a billable role, develop relationships with customer business sponsors, demonstrate CitiusTech consulting and domain leadership with transformative approach

Good to Have Skills

• Must have experience in clinical data systems, EHR systems
• Knowledge of denials data, Edits and scrubbing
• Strong understanding of data collection methodologies and regulatory requirements (HFMA)
• Ability to understand the client problem statement and strong analytical skills for identifying the possible solution
• Proven experience as a Business Analyst in major areas within RCM
• Proactive, adaptable to change with the ability to envision the final work product

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