Aparna Gangula Email & Phone Number

Eureka, Mo, Us

United States, Mo

• Understanding the business requirements and functional specifications from the client, CMS and States for enhancing, maintaining or customizing the Revenue 360 product.• Estimating the efforts required, preparing the design for the enhancements and customizations as per the requirements of the client and as per the compliance of Center of Medicare and Medicaid Services (CMS) / State Memos. • Develop/enhance the complex Cobol-Db2 modules to reconcile customer data with CMS/State data.• Prepare/review and signoff various levels of documentation like impact analysis, design, system integration test results and ensure that all the processes and checklists have been followed.• Process monthly reconciliations of plan expected system calculated payments and membership with CMS paid amounts and membership. Review the generated monthly reports thoroughly and release to the customer.• Preparing the adhoc reports as per the client requirements from the Revenue 360 database using complex SQL queries.• Extensive knowledge on DSP, Chip, StarKids, Star, Chip in Texas Medicaid. In New Mexico, New borns, Physical and Behavoral health codes, Long term care areas. Also, in Illinois, Long term care, most of the regions and rate cohorts etc.• Having frequent client visits, mostly during the monthly reconcilatoion process to address their concerns and gather new requirements.• Prepare test cases and perform the unit testing on the code changes performed. Involving in Integration and user acceptance testing.• To improve the performance of the application modules with my performance tuning skills. • Aligning to HIPAA act and maintaining PHI data privacy of the customers and their enrollees.Technical Expertise required for the execution of the project:COBOL, DB2, SQL, JCL, Endevor, Dtector, Insight, SPUFI, Dbeaver, Jobtrac.Standards:X12 - 834, 820, CMS MMR, CMS MOR, MPWRD, LISHIST, LEPD

Jefferson City, Missouri

EDPS/RAPS are Infocrossing Inc’s products to submit customer’s encounter/risk adjustment data to the Centre for Medicare and Medicaid Services (CMS) on their behalf. Using these products, Infocrossing is to validate and submit the customer’s encounters/RAPS data to CMS and calculate the risk score based on the MMR and MOR data from CMS. Performed as a product/technical lead role for a team of 6 members responsible for the product enhancement and production support, for 40 plus major US based health insurance companies to submit their encounter/risk adjustment data to CMS.Responsibilities:• Understanding the business requirements and functional specifications from the client and/or CMS for enhancing, maintaining or customizing the EDPS/RAPS products.• Estimating the efforts required, preparing the design for the enhancements and customizations as per the requirements of the client and as per the compliance of Center of Medicare and Medicaid Services (CMS). • Provide 24/7 production support in processing the continuous input files from the customers to process and submit to CMS thru EDPS/RAPS products.• Being a technical lead, I have designed and developed multiple COBOL-DB2 modules in this project to submit the encounter/risk adjustment data to CMS. Also responsible to conduct regular meetings with all my customers (weekly) and address their concerns and issues.• Preparing the adhoc reports as per the client requirements from the EDPS/RAPS database using my entensive SQL experience is joining multiple tables. • Prepare test cases and perform the unit testing on the code changes performed. Involving in Integration and user acceptance testing.Technical Expertise required for the execution of the project:COBOL, DB2, SQL, JCL, Endevor, Dtector, Insight, SPUFI, Dbeaver, Jobtrac.Standards:X12 - 837, 835, 834, 820, 999, 277CA, CMS MMR, CMS MOR, MAO002, MAO004, FERAS, RAPS,

Hyderabad, Telangana, India

I was a technical lead at Wipro Technologies during this time, for the client Honda of America. Our team was responsible for enhancing their GPCS (Global production control system) system, with the RLC expansion project.Technical Expertise required for the execution of the project:COBOL, DB2, SQL, JCL, Changeman, ESP.Responsibilities:• Understanding the customer requirements from business analyst.• Providing the technical design.• Develop the Mainframe modules to accomplish the requirements.• Deligate the development of few modules to the rest of the team based on the bandwidth.• Being part of Integration and User acceptance testing, and the deployment.• Providing warranty support.• Responsible and accountable for the tasks delivered by my team.• Mentor the team members to give enough functional knowledge for the quality delivery.• Onshore-offshore working model.

Hyderabad, Telangana, India

I started my professional career at Wipro technologies, as a mainframe developer for the client Schneider Electric North America who is a global leader in the electrical industry. As part of this project our team was responsible for providing application support and maintenance services for their applications Q2C (Quote to Cash) and FICO. Quote 2 Cash is an end to end application in which complete sales stream is maintained. FICO is their financial application where their Accounts payables and Receivables are managed.Technical Expertise required for the execution of the project:COBOL, DB2, SQL, JCL, Endevor, CICS, MQ Series, Power builder, Perigrine, Control-M.Responsibilities:• Understanding the customer requirements from the technical lead.• Developing/enhancing the changes requested, and unit testing the same.• Being part of Integration and User acceptance testing, and the deployment.• Providing production support and handling 24/7 oncall.• Figuring out the rootcause of repetitive failures and fixing them permanently.• Resolving the issues raised by the customer in form of tickets raised in Perigrine.• Tracking and meeting the tight SLA’s.• Onshore-offshore working model.

Ms In Software Engineering

WASE - Wipro Academy of Software Excellence. A collaborative course offered by Wipro and BITS Pilani.

Bachelor Of Science (B.Sc.), Electronics From Osmania University

Mpc

Ssc