# Nisha Thapaliya

Nisha Thapaliya is a remote worker on Himalayas, Healthcare Business Analyst at Excellus BCBS, based in United States.

Source: https://himalayas.app/@nishathapaliya

```text
Healthcare Business Analyst at Excellus BCBS, resolving EDI and FACETS data gaps across claims and enrollment.
```

| Detail | Value |
| --- | --- |
| Availability | Looking for a job |
| Location | United States |
| Authorized to work in | United States |
| Salary expectations | 120k+ USD |
| Job categories | Healthcare Business Analyst, Business Systems Analyst, Healthcare Systems Analyst |
| Skills | Healthcare Business Analysis, Business Systems Analysis, Requirements Elicitation, Claims Processing, Enrollment, Eligibility, Prior Authorizations, Medicaid, Medicare, PBMs, TPAs, Facets, Epic, Electronic Health Records (EHR), X12 |

## What I'm looking for

```text
I’m currently open to Healthcare Business Analyst, Business Systems Analyst, and Healthcare Systems Analyst opportunities.
```

## About

```text
At Excellus BCBS, I work on Claims and Enrollment enhancements in FACETS, identifying gaps between EDI transactions and system data. I analyze business rules and data mappings, and support system enhancements and UAT to help ensure accurate healthcare data flow.

At CarolinaEast Health System, I supported the transition from a legacy EHR to EPIC by documenting clinical workflows and integration requirements. Earlier, I worked on eligibility and benefits systems at Connecticut Department of Social Services and on FACETS claims and enrollment processes at Beacon Health Options.
```

## Experience

### Healthcare Business Analyst (current)

[Excellus BCBS](https://himalayas.app/companies/excellus-bcbs). Aug 2025 - Present

```text
Elicited and analyzed business requirements for claims and enrollment processing in FACETS, focusing on EDI integrations and data accuracy. Developed BRDs, FRDs, and managed Agile ceremonies while supporting system enhancements and UAT.
```

Skills: Facets, X12, SQL, Azure-DevOps, Jira, Power-BI, SoapUI, Balsamiq, Microsoft-Visio, Agile, Scrum, UAT, HIPAA, XML, REST-APIs

### Business Systems Analyst

CarolinaEast Health System. Aug 2023 - Jun 2025

```text
Supported the transition from legacy EHR to EPIC, documenting workflows and integration requirements. Gathered requirements, performed gap analysis, and managed Agile deliverables while creating wireframes and dashboards.
```

Skills: Epic, Electronic-Health-Records-(EHR), HL7, FHIR, SQL, Power-BI, Azure-DevOps, Balsamiq, Microsoft-Visio, UML, Agile, Scrum, UAT, REST-APIs, SoapUI, XML, JSON

### Business Systems Analyst

[Connecticut Department of Social Services](https://himalayas.app/companies/state-of-connecticut). May 2021 - Jul 2023

```text
Gathered and analyzed requirements for Medicaid, SNAP, TANF, and other state assistance programs. Authored BRDs, FRDs, and SRS documents, supported EDI transactions, and performed UAT and data analysis.
```

Skills: Medicaid, Medicare, SNAP, TANF, ACA, X12, SQL, Power-BI, Azure-DevOps, Microsoft-Visio, Lucidchart, Agile, Scrum, UAT, HIPAA, XML, MMIS

### Business Analyst

Beacon Health Options. Apr 2020 - Mar 2021

```text
Gathered requirements for Medicaid and behavioral health operations, focusing on FACETS claims and enrollment. Reviewed EDI 834 files, performed gap analysis, and supported UAT and integration testing.
```

Skills: Facets, X12, SQL, Jira, Microsoft-Visio, Lucidchart, SoapUI, Agile, Waterfall, UAT, HIPAA, XML, REST-APIs

## Education

### Lincoln University College

Master in Business Administration, Business Administration

```text
Pursued a Master in Business Administration from Lincoln University College, Nepal.
```

### Pokhara University

Bachelor in Business Administration, Business Administration

```text
Pursued a Bachelor in Business Administration from Pokhara University, Nepal.
```

## Tech stack

- Tableau
- Oracle
- Lucidchart
- Figma
- Azure DevOps
- Jira
- JSON
- XML
- Confluence
- Balsamiq
- SQL
- Power BI
- Epic

To contact Nisha, message them from this profile with a Himalayas employer account: [Hire on Himalayas](https://himalayas.app/hire).

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