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salesforce online training in india kphb hyderabadTechiemills course

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 – 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

Other Details:

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

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