Must Have Technical/Functional Skills
We are seeking a highly experienced Senior Analyst with strong expertise in the US Healthcare Payer domain. The candidate will play a critical role in analyzing payer-side business processes including claims, enrollment, membership, and benefits, while collaborating with business and technology teams to deliver scalable healthcare solutions.
Must-Have Technical / Functional Skills
Domain Expertise
• Strong experience in US Healthcare Payer domain(8 years)
• Deep understanding of:
o Claims processing lifecycle
o Enrollment & Membership
o Benefits configuration
o Billing and provider interactions
Healthcare Data & Standards
• Knowledge of:
o EDI Transactions (837, 835, 834)
o HL7 (good to have)
o FHIR standards (good to have)
• Understanding of HIPAA compliance requirements
Functional Expertise
• Strong experience in:
o Requirement gathering and documentation
o Business process analysis
o Agile methodologies (Scrum/SAFe)
• Experience with tools:
o JIRA / Rally / ALM
• Basic SQL for data validation and analysis
Preferred Skills
• Exposure to Medicare, Medicaid, and Commercial plans
• Experience with:
o Provider & network management
o Care management workflows
o Claims adjudication and payment systems
• Experience collaborating with data, integration, and downstream systems
Salary Range: $100,000- $140,000 a year
TCS Employee Benefits Summary:
Discretionary Annual Incentive.
Comprehensive Medical Coverage: Medical & Health, Dental & Vision, Disability Planning & Insurance, Pet Insurance Plans.
Family Support: Maternal & Parental Leaves.
Insurance Options: Auto & Home Insurance, Identity Theft Protection.
Convenience & Professional Growth: Commuter Benefits & Certification & amp; Training Reimbursement.
Time Off: Vacation, Time Off, Sick Leave & Holidays.
Legal & Financial Assistance: Legal Assistance, 401K Plan, Performance Bonus, College Fund, Student Loan Refinancing.
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