Business Analyst

Location: Kolkata, West BengalWork Mode: OnsiteShift: Night Shift / US Business HoursExperience Required: 6+ YearsEmployment Type: Full-TimeAbout the Role:We are looking for an experienced Business Analyst to analyse, document, improve, and support revenue cycle management processes for healthcare practices operating in the United States.The ideal candidate will have extensive hands-on experience across the complete medical billing lifecycle, including accounts receivable, denial management, eligibility and benefits verification, prior authorizations, payment posting, appeals, secondary billing, and client management.This role requires a strong combination of US healthcare domain knowledge, process analysis, client communication, documentation, reporting, and cross-functional coordination. The candidate will work closely with US-based clients, operations teams, product teams, software developers, quality analysts, and senior management to translate business and operational requirements into structured, scalable solutions.Key Responsibilities:Business Analysis and Requirement Management:Conduct discussions with US healthcare clients and internal stakeholders to understand business needs, operational challenges, and system requirements.Gather, analyse, and document functional and non-functional requirements.Translate business requirements into process flows, business requirement documents, functional specifications, user stories, and acceptance criteria.Identify gaps, inefficiencies, bottlenecks, and automation opportunities within healthcare RCM workflows.Support the design and implementation of scalable solutions for medical billing and revenue cycle operations.Maintain clear requirement traceability throughout the project lifecycle.Work closely with product, development, quality assurance, and implementation teams to ensure requirements are correctly understood and delivered.Revenue Cycle Management:Analyse end-to-end RCM processes, from patient registration and insurance verification through claim submission, payment posting, denial resolution, and collections.Provide subject matter expertise across:Accounts receivable follow-upEligibility and benefits verificationPrior authorization and authorization initiationCharge entry and claim submissionInsurance payment postingDenial posting and denial managementAppeals and reconsiderationsSecondary billingPatient billing and collectionsReview unpaid claims, ageing accounts, payment discrepancies, and reimbursement issues.Identify root causes of claim denials, underpayments, rejections, and delayed reimbursements.Recommend corrective and preventive actions to improve collections and reduce revenue leakage.Support the development of denial prevention, AR prioritisation, and claim follow-up strategies.Process Improvement and Automation:Document current-state and future-state RCM workflows.Conduct gap analysis and recommend improvements in people, processes, technology, and reporting.Identify repetitive and manual tasks that can be automated.Collaborate with technical teams to define requirements for RCM platforms, billing systems, dashboards, workflow applications, and AI-enabled solutions.Participate in system configuration, integration, migration, and implementation activities.Support user acceptance testing by preparing test scenarios, test cases, expected results, and defect reports.Validate that implemented solutions meet business, operational, and compliance requirements.Client and Stakeholder Management:Serve as a key point of contact between US clients, RCM operations, product teams, and technical teams.Conduct requirement-gathering sessions, process walkthroughs, status meetings, and solution demonstrations.Communicate project progress, risks, dependencies, and outstanding decisions to stakeholders.Manage client expectations and ensure timely resolution of operational and system-related concerns.Prepare meeting notes, action items, business reports, and executive-level summaries.Build strong relationships with clients by understanding their workflows, priorities, and revenue cycle challenges.Reporting and Performance Analysis:Analyse RCM performance using operational and financial data.Create and monitor reports and dashboards covering metrics such as:Days in Accounts ReceivableAR ageingClean claim rateFirst-pass resolution rateDenial rateCollection rateNet collection ratePayment turnaround timeAuthorization turnaround timeClaim rejection rateUnderpayment and payment varianceIdentify trends and recommend actions to improve operational performance.Present findings and recommendations to clients, management, and operational teams.Support periodic business reviews and performance improvement initiatives.Compliance and Data Confidentiality:Ensure that business processes and system requirements follow HIPAA and healthcare data confidentiality standards.Maintain confidentiality of patient, provider, payer, and client information.Support audit readiness by ensuring accurate process documentation, access controls, and traceability.Escalate compliance, payment, billing, or operational risks when identified.Required Qualifications:6+ years of experience in US healthcare revenue cycle management, medical billing, business analysis, or related roles.Strong subject matter expertise in accounts receivable and denial management.Hands-on experience with eligibility verification, prior authorization, payment posting, appeals, secondary billing, and insurance follow-up.Strong understanding of the complete US medical billing and claim lifecycle.Experience interacting directly with US-based healthcare clients or stakeholders.Ability to gather, analyse, and document complex business requirements.Experience preparing process flows, functional documents, user stories, acceptance criteria, and test scenarios.Strong analytical and problem-solving abilities.Excellent written and verbal communication skills.Ability to interpret operational data and recommend process improvements.Ability to work onsite in Kolkata during night-shift hours aligned with US business operations.Preferred Qualifications:Experience working as an RCM Subject Matter Expert, Team Lead, Process Analyst, or Client Manager.Certification in denial management, revenue cycle management, medical billing, or customer relationship management.Experience working with physician practices, independent healthcare providers, billing companies, or healthcare technology organisations.Knowledge of professional claims, institutional claims, payer portals, clearinghouses, and practice management systems.Understanding of CPT, ICD-10-CM, HCPCS, modifiers, EOBs, ERAs, and insurance reimbursement workflows.Experience with Medicare, Medicaid, commercial insurance, workers’ compensation, and secondary insurance billing.Familiarity with EHR, EMR, practice management, medical billing, or RCM software.Experience supporting product development, workflow automation, or healthcare software implementation.Familiarity with Agile, Scrum, Jira, Confluence, Visio, Excel, SQL, Power BI, or similar tools.Experience in healthcare recruitment or workforce coordination may be considered an additional advantage, but is not mandatory.Ideal Candidate Profile:The ideal candidate is an experienced professional who can transition from operational execution into structured business analysis and solution development.The candidate should understand the realities of medical billing operations, including unpaid claims, denials, authorizations, insurance follow-up, payment discrepancies, secondary billing, and client escalations. At the same time, the candidate should be capable of documenting workflows, analysing data, defining system requirements, and working closely with technical teams to improve or automate RCM processes.This role is suitable for someone who can communicate confidently with US clients, challenge inefficient processes, identify the root causes of revenue leakage, and convert operational problems into clear business and technology requirements.Work Requirements:This is a fully onsite position based in Kolkata, West Bengal.The candidate must be comfortable working night shifts aligned with US business hours.The role requires regular interaction with US-based clients and stakeholders.The candidate should be comfortable working in a fast-paced healthcare technology and RCM environment.