This role is for one of Weekday’s clientsMin Experience: 5+ yearsLocation: Remote IndiaJobType: full-timeWe are looking for a Claims Business Analyst with 5+ years of experience in healthcare claims operations, business analysis, and process transformation. The ideal candidate will have strong knowledge of payer/provider claims processes and experience identifying opportunities for process optimization, automation, and digital transformation.RequirementsKey Responsibilities:Partner with healthcare operations and IT stakeholders to assess current-state claims processes and define transformation roadmaps.Analyze end-to-end claims lifecycle, including eligibility verification, claims submission, adjudication, remittance, payment posting, denials, and appeals.Work with EDI 837/835 workflows and identify process gaps, manual interventions, rework, and delays.Analyze root causes of claim denials, inaccuracies, and operational inefficiencies.Identify opportunities for process standardization, optimization, RPA, and AI/ML-based automation.Leverage process intelligence and task/process mining tools such as UiPath, Celonis, or equivalent.Define and track business KPIs such as cycle time, accuracy, denial rate, productivity, and operational efficiency.Develop business cases, ROI models, and high-level process/solution concepts for automation initiatives.Partner with architects, developers, and RPA teams to translate business requirements into effective technology solutions.Support automation initiatives through discovery, process design, UAT, and hypercare from a functional perspective.Conduct workshops with claims operations, billing/coding, payer relations, and other business stakeholders.Present analysis, recommendations, and transformation strategies to senior stakeholders.Support change management, communication, and transition activities.Required Skills:5+ years of experience in healthcare claims, healthcare operations, business analysis, or business consulting.Strong understanding of healthcare claims processes and end-to-end claims lifecycle.Experience in claims process analysis, optimization, and transformation.Hands-on knowledge of claims adjudication, denials, appeals, prior authorization, and/or revenue cycle processes.Understanding of EDI 837/835 workflows.Strong stakeholder management, workshop facilitation, problem-solving, and analytical skills.Ability to translate business problems into process improvement and technology-enabled solutions.Experience working with both business and IT stakeholders.Good to Have:Experience with RPA, AI/ML, or intelligent automation initiatives.Experience with UiPath, Celonis, or equivalent process/task mining platforms.Experience developing automation business cases and ROI models.Experience with healthcare payer/provider environments.Knowledge of process mining, operational dashboards, and KPI frameworks.Experience supporting UAT, hypercare, and change management.Must-have skillsHealthcare Claims, Business Analysis, Claims Process Transformation & AutomationGood-to-have skillsRPA / Process Automation, EDI 837/835, UiPath / Celonis / Process Mining
This role is for one of Weekday’s clients
Min Experience: 5+ years
Location: Remote India
JobType: full-time
We are looking for a Claims Business Analyst with 5+ years of experience in healthcare claims operations, business analysis, and process transformation. The ideal candidate will have strong knowledge of payer/provider claims processes and experience identifying opportunities for process optimization, automation, and digital transformation.
Requirements
Key Responsibilities:
- Partner with healthcare operations and IT stakeholders to assess current-state claims processes and define transformation roadmaps.
- Analyze end-to-end claims lifecycle, including eligibility verification, claims submission, adjudication, remittance, payment posting, denials, and appeals.
- Work with EDI 837/835 workflows and identify process gaps, manual interventions, rework, and delays.
- Analyze root causes of claim denials, inaccuracies, and operational inefficiencies.
- Identify opportunities for process standardization, optimization, RPA, and AI/ML-based automation.
- Leverage process intelligence and task/process mining tools such as UiPath, Celonis, or equivalent.
- Define and track business KPIs such as cycle time, accuracy, denial rate, productivity, and operational efficiency.
- Develop business cases, ROI models, and high-level process/solution concepts for automation initiatives.
- Partner with architects, developers, and RPA teams to translate business requirements into effective technology solutions.
- Support automation initiatives through discovery, process design, UAT, and hypercare from a functional perspective.
- Conduct workshops with claims operations, billing/coding, payer relations, and other business stakeholders.
- Present analysis, recommendations, and transformation strategies to senior stakeholders.
- Support change management, communication, and transition activities.
Required Skills:
- 5+ years of experience in healthcare claims, healthcare operations, business analysis, or business consulting.
- Strong understanding of healthcare claims processes and end-to-end claims lifecycle.
- Experience in claims process analysis, optimization, and transformation.
- Hands-on knowledge of claims adjudication, denials, appeals, prior authorization, and/or revenue cycle processes.
- Understanding of EDI 837/835 workflows.
- Strong stakeholder management, workshop facilitation, problem-solving, and analytical skills.
- Ability to translate business problems into process improvement and technology-enabled solutions.
- Experience working with both business and IT stakeholders.
Good to Have:
- Experience with RPA, AI/ML, or intelligent automation initiatives.
- Experience with UiPath, Celonis, or equivalent process/task mining platforms.
- Experience developing automation business cases and ROI models.
- Experience with healthcare payer/provider environments.
- Knowledge of process mining, operational dashboards, and KPI frameworks.
- Experience supporting UAT, hypercare, and change management.
Must-have skills
Healthcare Claims, Business Analysis, Claims Process Transformation & Automation
Good-to-have skills
RPA / Process Automation, EDI 837/835, UiPath / Celonis / Process Mining
At Weekday (backed by YC; also Product Hunt #1 product of the day), we are building the next frontier in hiring. We have built the largest database of white collar talent in India and have built outreach tools on top of it to generate highest response rates.
At Weekday (backed by YC; also Product Hunt #1 product of the day), we are building the next frontier in hiring. We have built the largest database of white collar talent in India and have built outreach tools on top of it to generate highest response rates.
