Senior Business Analyst US Health Insurance

Atlanta, GA, US • Posted 5 hours ago • Updated 2 hours ago
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Job Details

Skills

  • Azure DevOps
  • UAT
  • Data Transformation
  • SQL
  • Data Migration
  • GAP Analysis
  • Jira
  • Power Bi
  • Data Governance
  • Requirements Management
  • Business Process Analysis
  • Claims
  • Stakeholder Management
  • User Stories
  • Acceptance Criteria
  • Business rules
  • Backlog refinement
  • Agile/Scrum
  • data reconciliation
  • Microsoft Fabric
  • Healthcare Data
  • Entity Resolution
  • Senior Business Analysis
  • US Health Insurance
  • Stop-Loss
  • TPA
  • Payer
  • Eligibility Rules
  • Claims Operations
  • Claims Data Quality
  • Duplicate Detection
  • Record Matching
  • Product Owner Collaboration
  • COBRA
  • COB
  • Enrollment & Eligibility

Summary

Senior Business Analyst US Health Insurance
Location: Atlanta, GA Onsite | Locals Preferred
Experience: 12+ Years
Role Overview

We are seeking a Senior Business Analyst with strong US Health Insurance, Claims, and Stop-Loss experience. The candidate will work closely with Product Owners, SMEs, business stakeholders, Engineering, and QA to translate complex claims and eligibility processes into clear, testable business rules and requirements.

Must-Have Skills

  • 10+ years of experience as a Senior Business Analyst
  • 8+ years in US Health Insurance, Stop-Loss, TPA, Payer, Claims, or Healthcare Data
  • Strong experience in requirements management, stakeholder management, process analysis, and backlog refinement
  • 5+ years defining business rules, eligibility criteria, rule catalogs, and data governance requirements
  • Experience with claims data quality, reconciliation, duplicate detection, record matching, and entity resolution
  • Strong gap analysis, problem-solving, and requirements clarification skills
  • Experience working with Product Owners, SMEs, Development, QA, and Project Managers
  • Strong communication and stakeholder facilitation skills
  • Experience with Agile/Scrum, Jira, or Azure DevOps

Key Responsibilities

  • Define and maintain claims, eligibility, data quality, and business rules
  • Own and refine the project backlog with Product Owners and stakeholders
  • Create BRDs, user stories, acceptance criteria, and UAT scenarios
  • Analyze claims processes, identify gaps, and resolve conflicting requirements
  • Define rules for duplicate claims, record matching, corrections, and reversals
  • Define member eligibility and follow-up rules
  • Facilitate requirements workshops and UAT sessions with business and claims SMEs
  • Partner with QA to develop acceptance criteria and UAT test scripts
  • Identify scope, requirement, compliance, and timeline risks
  • Define operational metrics and success measures
  • Bridge the gap between business stakeholders and technical delivery teams

Nice to Have

  • Enrollment & eligibility workflows
  • COBRA, Leave of Absence (LOA), and Coordination of Benefits (COB)
  • Healthcare claims and member eligibility experience
  • SQL for data validation and analysis
  • Data migration, transformation, and data quality experience
  • Exposure to Microsoft Fabric and Power BI

Ideal Candidate

A senior BA with deep US Health Insurance/Stop-Loss claims expertise, strong requirements and business-rule management experience, and the ability to work directly with business and technical stakeholders to deliver a modern Claims Management Platform.

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.
  • Dice Id: 10515154
  • Position Id: 2026-7203/42823
  • Posted 5 hours ago

Company Info

About Aroha Technologies

Michael Arrington, founder and co-editor of Tech Crunch once famously said that ‘The best startups generally come from somebody needing to scratch an itch’.

 Quite true to the thought, Aroha Technologies Inc was launched in 2008 in Florida. While we began our journey with a powerful Staffing Specialist & Software Development, Today our procedure has amplified into a more robust and simplified solution for Marketers looking for consistent and long term.

In our quest to do better, we resolve to simplify user acquisition, retention, engagement and large Business without blinking an eyelid! A semi-remote team spread across the globe, we are here to help you one step at a time.

Unmatchable growing excellence When AROHA was formed, we interviewed many potential clients and business colleagues and asked what a single important question seemed: “If you could design a firm to meet your needs, what would it look like?” The answers to that question have guided our thinking and planning on an ongoing basis, and form the core of our thinking about how we treat our clients and our employees, whom we call associates.

At a most basic level, we have stated our mission in a promise to our clients and our associates: “Unmatchable growing excellence.” This alignment governs superior service to our customers and supports our associates who perform that work, which cannot be matched by our competitors.

In short, we believe that care of our associates, disciplined financial management, and constant attention to the fundamentals of good delivery adds up to a successful, scalable business.

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