Dec 2022 – Nov 2023 · 11 mos · India

Feb 2018 – Nov 2022 · 4 yrs 9 mos · Noida, Uttar Pradesh, India

• Leveraged Python, SQL, and Machine Learning to develop predictive models and algorithms to identify potential healthcare fraud and abuse, saving the organization $X in annual losses.
• Conducted extensive data analysis and visualization using Power BI to identify patterns and trends in large healthcare datasets and generate insights to drive strategic decision-making for executive leadership.
• Led a team of junior analysts in performing data analysis and data cleansing using Excel to ensure data accuracy and completeness for reporting and analysis purposes.
• Applied NLP techniques to extract and analyze unstructured healthcare data from various sources, such as medical records and insurance claims, to improve the accuracy and efficiency of fraud detection and billing processes.
• Collaborated with cross-functional teams, including business stakeholders, data scientists, and IT developers, to design and implement data-driven solutions that improve the quality and efficiency of healthcare operations.
• Stayed up-to-date with industry trends and advancements in data science and healthcare analytics, and continuously improved technical and analytical skills to drive innovation and deliver value to the organization.

Sep 2015 – Jan 2018 · 2 yrs 4 mos · Noida, Uttar Pradesh, India

• Analyzed large and complex datasets using Python and SQL to identify patterns, trends, and insights that drive business decisions.
• Built and implemented machine learning models to predict healthcare outcomes, reduce costs, and improve patient care.
• Leveraged data science techniques to design experiments, conduct A/B testing, and measure the impact of various interventions on patient outcomes.
• Created interactive dashboards and visualizations in Power BI to communicate complex data insights to non-technical stakeholders.
• Developed and maintained complex Excel models for forecasting, budgeting, and financial analysis.
• Applied natural language processing (NLP) techniques to analyze unstructured data from patient feedback, social media, and other sources to gain insights and improve the patient experience.
• Collaborated with cross-functional teams including clinicians, operations, and IT to understand business requirements and develop data-driven solutions.
• Conducted ad-hoc analyses and data pull to support business needs and ensure data accuracy and integrity.
• Managed and maintained databases, ensuring data quality and accessibility for stakeholders.
• Conducted data exploration and cleaning to prepare data for analysis using tools such as pandas, numpy, and matplotlib.

Dec 2013 – Aug 2015 · 1 yr 8 mos · Noida

• Developed and maintained Python scripts to extract and preprocess data from various sources, such as claims and EHR systems
• Designed and optimized SQL queries to retrieve and join large datasets, enabling efficient data analysis and reporting
• Applied machine learning techniques, such as classification and regression, to build predictive models for patient outcomes and cost containment
• Conducted exploratory data analysis and statistical tests to identify trends and patterns in healthcare utilization and costs
• Created interactive dashboards and reports using Power BI, providing stakeholders with actionable insights and visualizations
• Utilized NLP techniques, such as sentiment analysis and topic modeling, to extract meaningful information from unstructured data, such as patient reviews and social media posts
• Collaborated with cross-functional teams, including clinicians, business analysts, and IT staff, to develop data-driven solutions for improving patient care and reducing healthcare costs.

Feb 2011 – Nov 2013 · 2 yrs 9 mos · Noida

• 1. Verifying insurance information and coverage for each claim to ensure timely and accurate payment.
• 2. Processing claims using various electronic medical billing systems, and performing data entry into the system.
• 3. Reviewing and analyzing claim data to identify and resolve payment discrepancies, and ensuring that claims are processed in compliance with regulations and industry standards.
• 4. Interacting with patients, insurance companies, and healthcare providers to resolve any claim issues or discrepancies.
• 5. Utilizing data analysis and statistical methods to identify trends, patterns, and inefficiencies in the claims processing system.
• 6. Developing and implementing data-driven solutions to improve the claims process and reduce payment delays.
• 7. Participating in ongoing training and education to stay up-to-date with industry changes and advancements in healthcare technology.
• 8. Collaborating with other departments, such as quality and compliance, to ensure that all claims are processed in a timely and accurate manner, and that all regulatory requirements are met.

Jun 2010 – Jan 2011 · 7 mos · New Delhi Area, India

• 1. Understanding the needs and requirements of clients and providing them with the appropriate services and solutions offered by Quikker.com.
• 2. Building and maintaining effective communication channels with clients to ensure their satisfaction with our services.
• 3. Identifying new business opportunities and developing strategies to retain and expand the existing client base.
• 4. Collaborating with other departments, such as the marketing team, to develop and implement customer engagement initiatives.
• 5. Resolving any issues or concerns raised by clients in a timely and professional manner.