Ramya Potlapalli Email & Phone Number

Long Beach

Worked on the reconciliation process for the Inbound and outbound files of Marketplace line of business between Molina and CMS. Generate the reports with the discrepancies in QNXT database by comparing data with the FFM Pre-Audit, Audit file of Exchange, Baseline files to the Enrollment, Finance department. Analyze results to identify early signs of trends or other issues related to eligibility. Will develop and present enrollment status, production and Key Performance Indicator reports to be used by senior management.Generate reports to identify appropriate reconciliation process to resolve data discrepancy and collection appropriate data to submit and resolve discrepancy. Generate and distribute various routine reports and Adhoc reports to support various operational needs according to the requirement. Will develop SSIS packages for the data transfer from various sources and provide user friendly reports for the Enrollment team using SSRS. Develop various queries according to the requirements from business like Health Check, QISC, Pre-Audit, Baseline/Recon, Premium billing, PPR, General Suspense, PCP reassignments, APTC and Non-APTC and various other attribute level reports.

Phoenix, Arizona Area

Worked on Encounter Data Management which is a reporting application used to prepare information on Medicare advantage or Medicaid patient encounters submitted to the Department of Health and Human Services, Center for Medicare/Medicaid Services (CMS) or Submitted to the appropriate state Medicaid agency.Designed SSIS packages for the data transfer from the OLTP and OLAP and also created few other packages for daily,weekly and monthly basis.Worked on Members, Providers and Claims related packages for both QNXT and Facets. Created Staging tables and also partitioned tables accordingly with partition key, Worked on Indexes and Stored procedures and Modified few packages so that data is sent to the staging tables.Worked with Priority Health on QNXT and Facets, this included both Encounters and Medical claim package.Implemented the package configuration and logging for the smooth transition between DEV, UAT, QA and PROD environments.

Bachelor’S Degree, Biotechnology

Master'S Degree, Bioengineering And Biomedical Engineering