Saima Batool Email & Phone Number

Dallas, Texas, United States

• Performed Data mapping to validate and customize Claims daily load into FACETS for processing the transactions.
• Create scrum calls with teammates in the morning and evening to get the report for the daily activity and in the evening meeting to ensure these tasks have been completed.
• Spend enough time each day with stakeholders to understand the flow of sensitive data
• Create a Visio diagram and an Excel spreadsheet for all data.
• Worked on Azure DevOps and created daily user stories with tasks for the team.
• Follow up with stakeholders and team for any dependency work/task.

Fort Worth, Texas, United States

• Involved in updating and/or reworking previous documentation on their Membership Enrollment System for Florida to get them in sync and up to date with their current new system in place.
• Developed generation process for QNXT configuration for utilization management team.
• Analyze and resolve production claims issues for Medicaid product
• Assist with the implementation and integration of EAM membership system into QNXT 4.7.
• Analyze and resolve all payment manager issues within QNXT.
• Involved in System Integration, Compliance and User Acceptance Testing and Validation of Medicaid claims processing and Electronic Data Interchange (EDI) translation in compliance with the 5010A

La Jolla Shores, California, United States

• Develop business process models for projects and demonstrations at the Centers for Medicare and Medicaid (CMS) using business process model notation and enterprise architecture.
• Worked extensively with developing business rules engine enabling the business rules
• Utilized Agile Software Methodology using Scrum framework.
• Actively participated in creating the user stories and prioritizing user stories along with tracking of burn up
• The process included importing claims into Facets that had been adjudicated and setting them in a "PAY" status so that a payment cycle could be run to create checks on Facets.
• Defined Data Maps to validate and customize Claims load inFACETS for the transactions

Pittsburgh, Pennsylvania, United States

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• Acted as a liaison between Business and IT throughout all phases of SDLC.
• Worked on analysis of FACETS claims and gathered requirements to comply with HIPAA
• Facilitated JAD sessions with all the important stakeholders for gathering requirements.
• Gathered requirements through one on one meetings with business owners.
• Documented all the requirements in blueprint.