Nov 2019 – Aug 2022 · 2 yrs 9 mos · Louisville, Kentucky, United States

• Contributed to a data-intensive initiative focused on improving the accuracy, efficiency, and timeliness of healthcare claims processing and provider lifecycle data management across distributed AWS-hosted systems. Supported development of large-scale ETL pipelines using Apache Spark and Scala to ingest, transform, and validate high-volume claims and eligibility datasets, ensuring cleansed, production-grade records were delivered reliably into downstream adjudication and analytics workflows. Implemented FHIR R4-compliant interoperability layers and HL7 messaging to enable standardized provider data exchange across disparate healthcare systems, and engineered EDI transaction processing pipelines supporting X12 standards for claims submission, adjudication, and remittance in full compliance with HIPAA audit and regulatory requirements. Applied ICD-10/ICD-11, CPT/HCPCS, LOINC, and SNOMED CT coding standards to support accurate claims validation, provider credentialing data mapping, and clinical reporting workflows. Integrated card tokenization and payment processing workflows to enhance secure member billing and reduce exposure to sensitive financial information across payer platforms. Leveraged intelligent automation, rules-based prioritization, and AWS MWAA (Airflow)-orchestrated workflow pipelines to reduce manual review effort, increase processing consistency, and minimize errors across end-to-end claims and eligibility lifecycle operations. Supported observability initiatives using Prometheus, Grafana, and AWS CloudWatch to monitor pipeline health, track claims throughput, and surface actionable operational insights for cross-functional stakeholders including clinical, operational, and IT teams. Contributed to dashboarding and trend identification efforts that enabled early issue detection and informed data-driven decisions across the provider lifecycle and claims processing ecosystem.

Jan 2017 – Oct 2019 · 2 yrs 9 mos · Cincinnati, Ohio, United States

• Contributed to the development of internal tools supporting underwriters in evaluating risk, reviewing cases, and performing card tokenization for secure financial transactions. Integrated with Guidewire PolicyCenter, BillingCenter, and ClaimCenter to streamline policy administration, premium processing, claims adjudication, and workflow management. Leveraged Duck Creek Policy, Majesco Policy, and Insurity Policy Decisions for multi-line product configuration, rating calculations, endorsements, renewals, and coverage checks. Implemented automation and business rules using Pega BPM and IBM ODM to optimize underwriting decision workflows, exception handling, and approvals. Ensured compliance with ACORD standards, ISO policy and loss codes, state-specific regulatory requirements, and EDI exchanges for standardized data transfer between internal and external systems. Built analytics and reporting dashboards using Tableau, Power BI, and QlikView to track exposure, loss trends, claims frequency, and underwriting performance. Integrated OCR-based document ingestion, third-party rating engines, and predictive actuarial models using SAS and R to improve underwriting accuracy and operational decision-making. Supported multi-line products, including property, casualty, specialty, and reinsurance lines, while automating policy lifecycle management, claims adjudication, and exception resolution. Operated in a collaborative, accountability-driven team environment emphasizing shared ownership, continuous improvement, and proactive problem-solving. Regularly contributed forward-looking process enhancements to improve efficiency, reliability, compliance, and trust across underwriting and claims operations.

Dec 2015 – Dec 2016 · 1 yr · Dallas, Texas, United States

• Contributed to the enhancement of a telecom billing platform at AT&T, aimed at improving accuracy, efficiency, and transparency across postpaid, prepaid, and enterprise billing processes. Collaborated with stakeholders to understand workflows, gather feedback, and implement enhancements leveraging Online Charging System (OCS), Billing Mediation, CRM integration, and Customer Care & Billing (CC&B) platforms. Automated repetitive billing tasks, rating calculations, usage aggregation, invoice generation, and reconciliation processes, reducing errors and improving operational efficiency. Integrated Diameter, SIP, and RADIUS protocol data for real-time usage tracking, coupled with EDI exchanges for external partner settlements. Applied ETL pipelines, data validation rules, and policy-based workflow orchestration to streamline billable events, discounts, taxes, and surcharges. Supported usage records processing (CDRs/IPDRs), call detail enrichment, and subscription lifecycle management, ensuring alignment with service-level agreements (SLAs) and regulatory compliance. Leveraged GIS mapping and spatial analytics to optimize network-based billing, location-based service charges, and regional promotions. Built reporting and analytics dashboards using Tableau, Power BI, and Informatica to provide insights on billing accuracy, revenue leakage, customer behavior, and geospatial usage patterns. Operated in a collaborative, cross-functional team environment emphasizing accountability, problem-solving, and active contribution to mission-critical features. Actively suggested process improvements and automation strategies to enhance productivity, maintain high-quality standards, and ensure trust and reliability in billing operations for residential, enterprise, and wholesale customers.

May 2014 – Oct 2015 · 1 yr 5 mos · Chennai, Tamil Nadu, India