Jan 2022 – Present · 4 yrs 4 mos · Austin, Texas Metropolitan Area

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Sep 2020 – May 2022 · 1 yr 8 mos · United States

• Created intelligent products that helped reduce cancellations, rescheduled, and no-shows in a provider setting. The product used a proprietary AI and ML solution which was built to process multiple data points and suggest appointment times that have high probabilities of patients showing up.
• Intelligence Team Creation: Formed a dedicated AI/ML intelligence team to address no-show, cancellation, and reschedule (NCR) issues, improving patient access and reducing costly missed appointments.
• Patient Preferences: Designed the app user interface to collect patient demographics and preferences, offering tailored appointment slots to reduce NCRs.
• Statistical Modeling: Used Association Rule Mining (ARM) to analyze NCR patterns and identify high-risk variables, enabling targeted appointment scheduling.
• AI/ML Optimization: Developed algorithms to match patients with low-NCR slots, reducing NCR rates and improving revenue predictability for healthcare providers.
• Dynamic Booking: Integrated an AI-powered dynamic tool to intelligently overbook and fill potential gaps, enhancing slot utilization and boosting revenue.
• Waitlist Feature: Created a waitlist feature allowing patients to secure preferred slots when available, minimizing appointment gaps and ensuring timely access to care.
• Self-Scheduling Tool: Developed a self-scheduling tool enabling patients to find and book appointments easily, eliminating the need for hospital calls and simplifying the process.

Sep 2018 – Sep 2020 · 2 yrs

• Transformed Medicare Enrollment & Retention at Highmark buy build an industry leading sales agent tool to stream line agent workflows and a redesigned member portal to simplify claims, benefits, billing and prior authorization accessibility with minimal member touch points.
• The solutions I deigned added 100k Medicare members driving a 30% YoY growth
• $640M in additional revenue
• Increased member retention by 97%, compared to industry standard of 85%
• Reduced customer case call volume by 70%

Apr 2017 – Sep 2018 · 1 yr 5 mos

• Highmark’s claims adjudication process faced high costs and resource demands, with 15% of claims requiring manual intervention. To address this, the Petitioner ideated and implemented Highmark’s first robotic claims adjudication application, revolutionizing the process. By spearheading the execution of robotic automation, claims were adjudicated efficiently, and payments to providers and patients were initiated seamlessly.
• A structured process was established to define adjudication requirements in alignment with BCBS and CMS guidelines. This included validating patient and provider details and diagnosis codes, standardizing and enriching claims data per system requirements, and applying adjudication rules to identify errors, duplicity, and claim amounts. Payment calculations were streamlined by cross-referencing claims data with payment schedules, provider contracts, and policy guidelines. Additionally, fraud detection and compliance processes were implemented to address duplicate and fake claims while adhering to HIPAA standards.
• This innovation reduced operational costs by 10%, saving $6 per claim as manual interventions dropped from 15% to 9%. The success of robotic claims adjudication led to the adoption of similar robotic processes in other workflows, such as enrollment and billing, further enhancing efficiency and combating fraudulent cases.

Jun 2016 – Dec 2016 · 6 mos · University of Pittsburgh

May 2016 – Mar 2017 · 10 mos · Greater Pittsburgh Area

Jul 2014 – Jul 2015 · 1 yr · Greater Delhi Area

Jul 2013 – Jul 2014 · 1 yr · Greater Delhi Area

Jul 2012 – Jul 2013 · 1 yr · Greater Delhi Area

Jun 2011 – Jul 2011 · 1 mo · Greater Delhi Area

• - Analyzed various options for selling the power and concluded that a long term power sale agreement with a power trader would result in power evacuation on priority and save a minimum of USD 2 MM/year.

Aug 2010 – Aug 2010 · 0 mo · Greater Delhi Area

• Operations of 210 MW Thermal Power Plant.

Jun 2010 – Jul 2010 · 1 mo · Uttarakhand, India

• - Coordinated across 5 disciplines to solve bottleneck and inventory issues related to manufacturing of electric generator stator bars thus increasing the production output by 3%.