Business Analyst - Health Insurance (Functional)

GSSTech Group

We are looking for a Business Analyst Functional with strong experience in the Health Insurance domain. The candidate will act as a bridge between business stakeholders, IT teams, and Third-Party Administrators (TPA) to ensure smooth implementation, enhancement, and support of health insurance systems and processes.

The ideal candidate should have solid knowledge of health insurance operations, policy administration, claims processes, and regulatory requirements, with the ability to translate business needs into functional specifications.

Key Responsibilities

Work closely with business users, IT teams, and TPA partners to gather and document business requirements.

Analyse health insurance business processes, including policy lifecycle, claims management, underwriting, and provider network management.

Translate business requirements into functional specifications, use cases, and process flows.

Support system implementation, enhancements, and integration projects related to health insurance platforms.

Coordinate with TPA systems and internal IT teams to ensure seamless data exchange and process integration.

Conduct gap analysis and recommend system or process improvements.

Participate in UAT (User Acceptance Testing) and validate system functionality against business requirements.

Support issue resolution by working with IT teams and business stakeholders.

Prepare documentation including BRD, FRD, test cases, and user guides.

Ensure solutions comply with insurance regulations and organizational policies.

Required Skills

Strong understanding of Health Insurance business processes.

Experience working with TPA systems and insurance platforms.

Ability to prepare BRD, FRD, use cases, and process documentation.

Experience in requirements gathering, stakeholder management, and UAT coordination.

Good understanding of system integrations and data flows between insurance systems.

Strong analytical and communication skills.

Preferred Qualifications

Experience working in insurance companies or healthcare insurance providers.

Familiarity with insurance core systems or policy administration systems.

Knowledge of regulatory requirements in the insurance sector.

Experience working in Agile or hybrid project environments.

Education

Bachelor’s degree in Business Administration, Information Systems, Computer Science, or related field.