Sr Claims Encounters Analyst
CurrentI have been working for CareSource for over 5 and half years. I worked in several teams across multiple departments and played several different roles.Some of the projects/ roles that I worked on:1) Bridge To Home(BTH): • Responsible for the requirements gathering, design, development, testing, deployment and maintenance of the Bridge to Home project.2) BI reporting: • Created several new reports in various formats like RTF, HTML, XLS, TXT, Pdf, CSV etc using Base … Show more I have been working for CareSource for over 5 and half years. I worked in several teams across multiple departments and played several different roles.Some of the projects/ roles that I worked on:1) Bridge To Home(BTH): • Responsible for the requirements gathering, design, development, testing, deployment and maintenance of the Bridge to Home project.2) BI reporting: • Created several new reports in various formats like RTF, HTML, XLS, TXT, Pdf, CSV etc using Base SAS, SAS EG and SQL Server Reporting Services (SSRS).3) ICD-10 Project & Automation:• Worked on As-Is To-Be analysis of the ICD 9–ICD 10 Conversion of the SAS Jobs and processes.4) SAS and Facets Upgrade Projects:• Performed Unit testing, Integration testing, black box testing, regression and functional testing.• Assisted the business users with the User Acceptance testing and documented all the test results on the HP Quality control to track down all the defects.5) Encounter & Regulatory Data Submissions:• Worked with the Encounters team for the data extraction and data submissions of the claim and encounters data using both SAS, SQL, SSIS.• Was a part of the “Encounters Tiger Team” to pull in the claims processed and the encounters submitted and provide a relationship between them to the higher management.• Extracted and handled huge amounts (millions) of claims and encounters data efficiently.7) ACG – Population Stratification:• Created the input files, SAS Datasets needed for the ACG Software which creates the risk Population groups, risk scores, ADG, EDC etc based on several factors.8) Enrollment – BI Developer: • Developed new SSRS reports and Power BI dashboards and maintenance of existing reports.• Designed and developed stored procedures, triggers, indexes, queries and views as needed.• Used table variables and Common table expressions.• Created and maintained several SSIS packages to extract data from different sources Show less