Healthcare Insurance BA (SME)

10-12 years of Health SME (Subject Matter Expert) experience in health care indemnity plans. Health, Hospital/Wellness, Cancer, Critical Illness, MEC1-Skinny Limited Medical, MEC2-Limited Medical, MEC3-Limited Medical products expertise is a must in US region. Proven experience with underwriting processes, policy admin systems, claims process, benefit configuration, Form generation, and integrations with down and upstream systems. Proven experience in implementing Health portals following ANSI EDI standards. Experience with Health insurance systems for carriers and MGAs Exposure to Medicaid and Medicare systems Knowledge and Experience in billing, Claims, HIPAA regulations, EDI files Proficiency in requirements gathering, process modelling and documentation bility to collaborate with stakeholders at all levels internally and clients Familiarity with industry specific tools for policy administration, claims management and underwriting Experience in integration of core system with portals and apps. Extensive experience in functional integration with associated third-party systems