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Business Analyst (Healthcare Domain) Training Roadmap - Zarantech


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More Info on HealthCare Domain visit,

More info on BA Training visit,

Contact Info: 515-978-9777 (or) Email -


Health Insurance - Overview:
1. What is Health Insurance
2. Components of Health Insurance
3. Types of Health Insurance Coverages
4. Types of Health Insurance (HMO, PPO, POS)
5. Provider vs. Payer, and NPI
Claims Process:
1. Claims Process Flow
2. Claims Submission
3. Claims Adjudication Processing
4. Encounters Submission
5. Compliance Check
EDI Transactions-I:
1. 837 EDI Claims; 835 Remittance
2. Edits and Validations
3. Reports and Acknowledgements
EDI Transactions-II:
1. Other EDI 5010 Transactions
2. ICD-10 Impacts
3. ICD-10 Implementation Roadmap
5. TR3 Documentation, Companion Guide
Facets - Overview:
1. Facets Functional Modules
2. Data Model
3. Pricing Workflow
4. DRG Processing
5. HIPAA Compliance
Health Information Exchange:
1. Affordable Care Act / Govt Reforms
2. Electronic Medical Records
3. Healthcare Exchange
4. Review Templates/Sample Artifacts

- Over 20 years of IT experience in diversified industries -- Healthcare, Auto, Retail, Manufacturing, Utilities and Defense.
- 12 years of structured Project Management experience.
- 7 years of training experience in Project Management, Business Analysis, and QA Testing.
- Experienced with software development methodologies -- waterfall, RUP, Agile.
- Education: Master in Software Engineering and Administration, CMU.
- Certification: PMP, ITIL, EMR & Health Exchange.

Published in: Education
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Business Analyst (Healthcare Domain) Training Roadmap - Zarantech

  1. 1. BA HEALTHCARE DOMAIN Professionals Competency Development Program – Session Schedule We focus on delivering Role-Specific training rather than Product based Training BUSINESS ANALYST TRAINING PROGRAM (HEALTHCARE DOMAIN) ROADMAP Familiarize with Terminology and Concepts Introduction to Healthcare h c Understanding the Claims Pricing Model Government Health Plans (Medicare and Medicaid) EDI Transactions and Data Format (4010/5010) r a L e T n a C L SDLC Claims Data Submission to States/CMS Claims Process Overview Diagnosis Coding and Procedure Coding System (ICD-10) Government Regulations and Guidelines Discuss Real-Time BRD’s and Test-cases Z Zaran Tech LLC. ,, , (515) 309-7846, Page - 1 5550 Wild Rose Lane, Suite 400, West Des Moines IA 50266