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Business Analyst - Health Care

About Course

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 – 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 – 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

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