Business Analyst


About The Course


Course Duration: 192 hours

Intended Audience:

This course is intended for those who want to work as a Business Analyst

Prerequisites:

Knowledge of Computer Basics like A+, Network Basics and Microsoft office. Students are required to have at least High School Diploma or GED along with a good knowledge of computer.

Healthcare Domain Business Analyst Training 

1. Health Care Terminology (Subscriber • Member • Provider • Claims • Coinsurance • Copayment • Deductible PHI • HIPAA • Health Care Plans • COB • TPL • ICD Codes – ICD9 vs. ICD10 • HL7 etc.)

2. Commercial Health Care Plans (PPO, HMO, Supplemental Insurance, MediGap etc.

3. Government Health Care Plans 

4. HIPAA Basics • HIPAA Transactions 

5. Healthcare claims –

• 837 - Claims submission (Professional / Institutional and Dental)  
• 835 – Payment and advice 
• 834 - Enrollment (Benefit Enrollment and Maintenance) 
• 270/271 – Eligibility and Benefits (Health Care Eligibility Inquiry and Response)
• 278 –  Authorization (Health Care Services Request for Review and Response) 
• 4010 to 5010 conversion
• EDI transactions 
• Integration with product composer and pricing system 

6. Health Care system configuration and Claim operations 

• Member Management 
• Provider Management
• Duplicate claim verification 
• Benefit determination
• Pricing
• TPL / COB edits and more
• ICD 9 to ICD 10 Conversion

7. BA related concepts – 

• Requirements Traceability Matrix
• Change Request Management
• Configuration Management
• Types of business situation analyses by doing GAP analysis 
• Requirements Gathering Techniques
• Elicitation
• Business Rule Analysis
• Documentation Analysis

8. Process Analysis by creating - 

• Use Case Diagrams
• Activity Diagrams
• Swim Lane Diagrams
• Use case template
• Writing user stories 
• User guide and implementation documentation

9. System and claim Error code and adjustment code configuration 

     Aepona      AIG      Ciber      Cognizant      Costco      CVS      Danya            Futrend      Futrend      KIPT      KIPT      Mphasis      NEC      OPC      Pfizer      Prokarma      T-Mobile      Trizetto      Walgreens      Xavient     

Copyright © 2017 PeopleNTech Institute of Information Technology.
All rights reserved.| Developed By PeopleNTech Software