Nov 2015 – Dec 2019 · 4 yrs 1 mo

• Responsible for extracting business requirements around integration sources, code sets and reference data collection for the purpose of creating harmonized data.
• Assisted in the exploration and determination of business data consumption targets and strategies for matching repository data to achieve business requirements.
• Interpreted data, analyze results using statistical techniques and provide ongoing reports
• Worked on the EDW platform bringing in EMR/EHR data, billing data, cost data and patient satisfaction data.
• Expertise in utilizing various source system data in order to report on HEDIS, CMS, MIPS and MACRA measures.
• Analyzed techniques to reuse the AHRQ tool and produced patient safety reports and quality reports for providers.
• Managed a team of 5 and helped the team increase their functional knowledge of the US healthcare Industry.

Oct 2010 – Oct 2015 · 5 yrs · Greater Houston

• Requirements analysis and requirements gathering for EMR applications including UI design.
• Translated business requirements to technical requirements for building a comprehensive application and functionalities into the new standardized system.
• Created functional design documents and the QA team in test design, conditions, and scripts.
• Worked on EHR workflows around care process, patient admission, labs and e-prescription‏.

Jun 2009 – Apr 2010 · 10 mos · Pune/Pimpri-Chinchwad Area

• claims adjudication
• claims audit
• Coordinating with concerned claimant, requesting more information and explaining the process as per requirements
• Excessively worked with Third party claims
• Processing claims where Insured party is at fault