Amreen K. Email & Phone Number

Washington, DC, US

Long Beach, California, US

Long Beach, California, US

Long Beach, California, US

• Elicited requirements from end users to solve a business problem and identify the desired results.
• Create and grooming the product backlog based on the prioritization and discussion with cross-functional and technical teams
• Facilitating daily scrum, sprint planning, sprint demo and retrospective meetings
• Keeping the organization, particularly the project’s stakeholders, up to date on the progress of the scrum team’s projects
• Provided extensive coordination and assistance to the Quality Assurance, Development, Operations, and Production teams, and actively contributed to project scheduling, preparing meeting minutes, templates.
• Facilitated effective sprint planning sessions, daily stand-ups, sprint reviews and retrospectives, promoting team ownership

Baltimore, MD, US

• Utilized detailed understanding of the claims domain to update existing process documentation to meet claim engine technical requirements.
• Utilized Blue Web (FAM Vol II) and FEPDirect to develop and test requirements for Medicare, Medicaid, Master files and Compatibility Edits.
• Effectively used ALM to add requirements, create libraries, complete PRL sign off, and baseline requirements
• Worked collaboratively with the business/technical team to document functional and nonfunctional business technical requirements to improve claim accuracy, processing and reimbursement.
• Conducted walk-through sessions to review Functional, nonfunctional and interface requirements with the development, testing, and Director’s office teams to ensure the accuracy of requirements.
• Meticulously analyzed complex claims data, rules, process flows and claim edits to recommend solutions to improve business processes.

Dublin, OH, US

• Participated in Joint Application Development (JAD) session with the team and the Stakeholders to analyze business scope and flow
• Utilized corporation developed Agile SDLC methodology
• Worked with the business/functional unit to assist in the development, documentation, and analysis of functional and technical requirements within FACETS
• Wrote Epics and user stories, managed sprints and backlog grooming, and tracked project progress in JIRA
• Expertise in Claims, Subscriber/Member, Plan/Product, Claims and Provider of Facets. Used Facets support systems to enable inbound/outbound HIPAA EDI transaction in support of HIPAA 834, 835, 837 270/271 transactions.
• Interacted with Claims, Payments and Enrollment hence analyzed and documented related business processes

• Participated & designed a new matrix covering all the conceptual parameters of the new system as per the need of the business.
• Extensive knowledge on relevant cross-industry data & messaging standard organizations & HIPPA/EDI industry-specific organizations to maintain a point of view as to the current applicability & risks associated in.
• Experience with HL7 V2.x healthcare interface standards & HIPAA requirements for electronic healthcare transaction
• Worked on all Major HL7 interfaces: ADT (Admit Discharge Transfer), SIU (Scheduling Information Unsolicited), ORM (Order Response Message), ORU (Observation result Message)
• Detailed working knowledge & hands-on experience with HL7 interfaces technical analysis & development
• Worked on requirements related to Booklets, ID Cards, EOB’s, EOP’s & Customer Service portal

• Involved in gathering the requirements from business to determine the users of the system and the functionality that should be provided to them.
• Conducted JAD sessions and walkthroughs to gather the requirements.
• Tracked business Requirement Traceability Matrix (RTM) and handled scope creeps.
• Elicited and decomposed requirements related to Claim Adjudication and Reimbursement processes, and billing, banking SMEs to finalize business requirements.
• Determined which claim system to interact with to display data on the UI.
• Proactively communicated and collaborated with an internal/ external business community and the IT team to analyze information needs and functional requirements.

Tampa, Florida, US

• Worked closely with business team, and identified, analyzed the core requirements and key features of the ongoing project. Extracted, discussed, and refined business requirements and developed comprehensive business.
• Involved in HIPAA EDI transactions such as 270, 271, 837 (P, D, I), 276, 277, 834, 835, 820, 278, 999/TA1, and 277 CA.
• Evaluated Medicare requirements and benefits in Medicare Health Plans for member enrollment and management.
• Coordinated, implemented and provided on-going support of the Quality Performer as outlined in the Specifications Manual for Well Care Inpatient Quality Measures Centers for Medicare & Medicaid Services (CMS).
• Used HP Quality Center for writing Test plans and Test Cases.
• Worked on documenting business rules to be defined in the business rules management engine (IBM ODM).