Business Analyst Health Insurance (Agentic IVR / Agentic AI)_Boston, MA (Onsite_Need Local_No Relocation_F2F Interview))

Overview

• We are looking for an experienced Business Analyst with strong expertise in the US Health Insurance domain and exposure to Agentic IVR / Conversational AI initiatives.
• The ideal candidate should have experience working with payer operations, contact center workflows, and enterprise-level Agile programs.

Key Responsibilities:

• Gather, analyze, and document business requirements for Agentic IVR and Conversational AI use cases
• Work closely with business SMEs to define IVR journeys and conversational workflows
• Understand payer workflows including Claims, Eligibility, Benefits, Prior Authorization, Enrollment, Billing, and Pharmacy
• Translate business rules and decision logic into conversational AI solutions
• Support UAT, Pre-UAT, and Go-Live activities
• Ensure compliance with HIPAA, PHI/PII masking, and payer regulations
• Collaborate with cross-functional teams in Agile/Scrum environments

Required Skills:

• Strong experience in US Health Insurance / Payer domain
• Knowledge of Claims, Eligibility, Benefits, Enrollment, Member Services, and Authorizations
• Experience supporting IVR, Contact Center, or Conversational AI projects
• Expertise in BRD, FRD, User Stories, and Acceptance Criteria
• Hands-on experience with Jira & Confluence
• Understanding of HIPAA, PHI/PII masking, and compliance requirements
• Excellent communication and stakeholder management skills