Senior Analyst US Healthcare Payer Domain

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.

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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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