Health care Business analyst

Business Analysis with Healthcare domain knowledge combines with Business Analyst skills to give a customized skillset for an individual looking to make a career as a Business Analyst in the Healthcare domain. This explores many business processes, use cases at every point of contact where the patients interfaces with the healthcare professionals. A Business Analyst should equipped with clinical trial knowledge and with various tools usage like HPQC- ALM, MS Visio, etc.

Introduction to Business analysis

Importance of BA

Business architecture

Role and responsibilities of BA

Objective need and scope

Project vs product based IT companies

SDLC

Knowledge areas:

• Enterprise analysis
• Requirement planning and Management
• Elicitation, analysis and documentation
  • ( Business, functional, nonfunctional requirements )
• Communication of requirements
• Solution assessment

JAD Sessions,

OOAD & UML

User stories in agile process

BA Tools:

• MS VISIO
• Enterprise Architect
• Rational rose

Basic health insurance terminology

• What is Health Insurance and why it is required.
• What is HIPPA?
• Indemnity Plans â?? All plans
• Managed Care( HMO, PPO,POS)
• Medicare
• Medicaid

Basic terms

• Subscriber/Member
• Provider
• Claims
• COBRA
• Capitation
• Co-pay
• Co-insurance
• Fee-For-Service
• Deductible

LIMIT

• COB
• EOB
• Procedure codes
• Diagnosis codes,
• Accumulator
• ICD with examples wherever possible.

FACETS OVERVIEW

• What is Facets, version of Facets and its modules?
• Extension
• What are Extensions
• Types of Extensions.
• Configuration of Extension

FACETS DATA MODULE

• Accounting
• Accumulator
• Application support
• Benefit Configuration
• Billing
• Hippa
• Capitation
• Claims Process

CLAIMS PROCESSING â?? ITS

• Commission
• Criteria
• Customer Service
• Dental Plans
• Dental provider agreement
• FSA Plan
• ITS Application Support

ITS PLAN

• Medical Plan
• Provider NetworkX
• Provider agreement
• Pricing Profile
• Provider
• Subscriber
• Utilization Management
• Workflow Configuration

Other Details:

• Duration: 5 weeks
• Mode of session: Online
• Fee: 20,000
• Trainer: 
• Material, Video recordings, FAQâ??s, Technical white papers will be provided to the student.