BA - Healthcare (Process Transformation & Automation)

This role is for one of Weekday’s clients
Min Experience: 5+ years
Location: Remote India
JobType: full-time

We are looking for a Business Analyst – Healthcare with 5+ years of experience in healthcare operations, claims, business analysis, and process transformation. The ideal candidate will have strong knowledge of healthcare claims and payer/provider operations, along with hands-on experience in process mining, task mining, and automation-led process improvement.

Key Responsibilities:

• Conduct detailed analysis and documentation of healthcare workflows, including claims adjudication, prior authorization, denial management, and revenue cycle processes.
• Collaborate with healthcare clients and business stakeholders to gather requirements, identify pain points, and understand current-state processes.
• Create process maps, data-flow diagrams, and detailed process documentation using process and task mining insights.
• Analyze process mining and task mining data to identify bottlenecks, inefficiencies, manual activities, and automation opportunities.
• Quantify automation opportunities and develop ROI calculations and business cases.
• Use task mining to understand user interaction patterns and accelerate process discovery and documentation.
• Work closely with RPA developers and technology teams to translate business requirements into functional and technical specifications.
• Develop business cases and value propositions for automation initiatives across claims processing and revenue cycle management.
• Drive process standardization, re-engineering, and optimization across claims intake, validation, adjudication, denials, and related workflows.
• Support automation implementation, UAT, change management, and post-implementation activities.
• Conduct workshops and communicate findings, recommendations, and transformation strategies to business and technology stakeholders.

Required Qualifications:

• 5+ years of experience in healthcare claims operations, business analysis, business consulting, or process transformation.
• Strong understanding of the healthcare claims lifecycle, payer-provider interactions, and revenue cycle management.
• Strong knowledge of claims processes including EDI 837/835, prior authorization, eligibility, adjudication, denials, and appeals.
• Hands-on experience with process mining and task mining tools such as UiPath, Celonis, or equivalent.
• Knowledge of RPA platforms and automation concepts, with UiPath preferred.
• Strong capabilities in business analysis, process re-engineering, requirements gathering, and process optimization.
• Experience developing ROI calculations, business cases, and value propositions for automation initiatives.
• Experience with process mapping methodologies and tools.
• Good understanding of HIPAA and healthcare regulatory requirements.
• Excellent stakeholder management, communication, analytical, and problem-solving skills.
• Ability to translate business challenges into technology-enabled solutions.

Preferred Qualifications:

• Experience with healthcare claims platforms such as Epic (Resolute HB/PB), Facets, TriZetto, Availity, or Change Healthcare.
• Experience with healthcare payer/provider transformation or consulting engagements.
• Experience with Carelon, Availity, Quanum, or comparable healthcare platforms.
• UiPath Process Mining, Task Mining, or RPA certification.
• Lean or Six Sigma certification or experience.
• Working knowledge of SQL and data analysis.
• Familiarity with HL7, FHIR, or healthcare interoperability standards.
• Exposure to AI-led transformation and automation use cases in healthcare operations.
• PMP or Agile certification.
• Experience supporting UAT, change management, and implementation/hypercare activities.

Success in this role will involve identifying high-value transformation opportunities, delivering automation initiatives with measurable ROI, reducing claims processing time and manual effort, improving denial and rework rates, and enabling stronger process visibility and governance through data-driven insights and KPIs.

Must-have skills

Healthcare Claims / Claims Operations, Business Analysis, UiPath Process Mining / Task Mining

Good-to-have skills

RPA / UiPath, EDI 837/835 / HIPAA, Healthcare Claims Platforms – Epic / Facets / TriZetto / Availity