Business Analyst Finance
Business Analyst Health care :
There are many Insurance domains, but 70% of business analysts in insurance domain are from healthcare insurance domain. So I am going to discuss Healthcare domain knowledge only.
Main things a Healthcare Business analyst in Insurance domain should have below things.
1. Understand what is Medicare and Medicaid systems. Medicaid is a state government run program for poor people. Medicare is a central government run program for aged people over 65 years.
When working as a business analyst in healthcare insurance company you must have good understanding of these system because lot of Medical and hospital calims process based on these payment terms.
Know about Medical claims, Hospital claims differences. Provider knowledge is must. Procedure codes, diagnosis codes knowledge is very important. Also understand terminology of Copayments, deductibles, Limits, coinsurance etc.. Infact you must also prepare for the business analyst interview questions which are usually asked in the interviews. This is very important..
Business Analyst role is to analyze the business processes, provide the right mixture of technical and functional know how to the development of software projects within an organization. If we talk specifically about an Insurance organization, the business analyst will have to possess the right niche of Insurance knowledge as well as be fluent in the latest technologies.
The major responsibilities of a business analyst should be to analyze the business processes, gather the requirements and and finally document those requirements in line with the strategic initiatives of the Insurance company. But in order to provide solutions which are innovative and cater to the nuances of the insurance industry, its essential that the business analyst should have an understanding of the insurance processes, modules, concerned departments and latest technologies available in the market. This will enable the business analyst to identify any project or business related risks and if present, to propose suitable action to mitigate those risks. Along with ability to do the requirement analysis and documentation, business analysts should be proficient in other vital activities such as good communication skills, project management, Testing skills, providing user acceptance testing support. The specific user requirements in any particular industry are different and its true for the insurance industry where the workings of the sales, HR, operations and other teams are unique and so should be the systems and processes built around them. If you are prepering to attend for Salesforce BA then go and read other post Salesforce Business Analyst roles and responsibilities.
Functional requirements of a prospective business analyst candidate is that he has demonstrable experience in an insurance company, worked on insurance applications catering to the various modules of insurance like new business, channel management, policy servicing, claims management, underwriting, reinsurance and Finance. The prospective business analyst candidate should be aware about the business processes and workings of the insurance company. The candidate should also be aware of the requirements which are given by the regulatory authority of the insurance industry. There are various terminologies which are unique to the insurance industry whether its life, general, health insurance. Knowing the terminology relevant to the insurance industry will help the business analyst in understanding the user's expectations and needs and will be able to effectively convert these expectations to requirements. There are various streams of insurance industry where a business analyst can add value:
a) Life Insurance � where the risk of mortality, critical illness is covered. Basic knowledge of the various modules and special regulatory guidelines are required
b) General Insurance � Includes fire, household, marine, motor and other such streams of insurance. The operations of this domain is different that the life insurance and the knowledge of operations intricacies, reinsurance business processes are vital for a business analyst
c) Health Insurance � covers the risk of morbidity and the specific know how required of this stream is the operations of the panel doctors, cashless reimbursements, co payments and other such typical health insurance terminology.
A Business Analyst seeking a job in an insurance company should be experienced in the technologies such as MS � office tools(which include Word, Excel, Powerpoint, Visio, Project), Relational Databases(Querying and support), basic programming skills in languages such as ASP.NET, JAVA/J2EE, XML, HTML. Also required are experience in specific insurance business applications, content management systems, Portals, data warehousing tools. These tools will enable the candidate in the future projects in which the customization and change management will be required. For the successful implementation of such projects , it essential that the business analyst has prior knowledge of such software systems or packages.
So, in summary, a prospective business analyst should come from an insurance background with the knowledge of the insurance business processes and relevant software packages.