Business Analyst

About

Description

As a Business Analyst, you will be responsible for collaborating across departments to define business needs, optimise digital solutions, and deliver enhancements that improve claims processing accuracy, speed, and compliance. You’ll contribute expert insights into medical aid claims processes, identify inefficiencies, and help implement improvements that directly impact member and provider experiences.

Responsibilities

• Gathering and translating complex business requirements into functional specifications, with a primary focus on claims rules, adjudication processes, and system logic
• Validating system outputs against scheme rules and benefits to ensure accurate claims processing and member experience
• Working closely with claims assessors, business owners, and developers to align system functionality with operational requirements
• Interfacing between the business and development teams to support implementation of system changes that improve claims automation, reduce errors, and increase efficiency
• Conducting root-cause analysis on claim-related issues and trends, and proposing corrective or preventive actions

Qualifications

• Grade 12
• Bachelor's degree in a relevant field such as Information Technology, Business, Finance or Economics, or a related field
• Minimum of 5 years’ experience in business analysis, preferably within a medical claims or healthcare administration environment
• Strong understanding of claims processes, rules engines, benefit structures, and ICD/CPT coding
• A relevant IT qualification and Medical Aid industry knowledge or background would be beneficial

Application instructions:

• Click on green button to apply!!