Headline

Immediate joiner | 6 Years of Experience in US Healthcare | Senior Quality &Audit Representative | Reporting Analyst | Medicare, Medicaid & Commercial Claims | SQL | Power BI | Data Analytics | Process Improvement

About

Optum benefits from expertise in process and change management, supported by a B.Com in Computers from Siddhartha Degree College. Currently serving as Senior Claims Associate and Reporting Analyst, they contribute to operational efficiency through Lean Six Sigma methodologies. Previous experience as a Process Consultant at HGS enhanced their skills in streamlining workflows and supporting organizational improvements. Their collaborative approach ensures successful project outcomes and process enhancements.

Location

Pune/Pimpri-Chinchwad Area

Work experience

Reporting Analyst at Optum, Dec 2021 - Present · 4 yrs 8 mos, Hybrid, • Analyzed healthcare claims data using SQL, Excel, and Power BI to identify trends and support business decision-making. • Developed interactive dashboards and KPI reports by integrating data from multiple sources, improving visibility into operational performance. • Created data models and visualizations in Power BI, transforming complex datasets into actionable insights for stakeholders. • Evaluated claim processing accuracy by reviewing 100+ claims daily, ensuring compliance with CMS regulations and internal policies. • Collaborated with cross-functional teams to gather reporting requirements and streamline data workflows, reducing report development time by 25%. • Investigated claim processing errors and discrepancies through root-cause analysis, improving claim quality and operational efficiency. • Supported claim automation initiatives by acting as a liaison between business and automation teams, contributing to process optimization and workload reduction. • Implemented high-risk, high-dollar claim verification processes, reducing false-positive claim rejections and improving provider satisfaction.

Process Consultant at HGS - Hinduja Global Solutions, Feb 2020 - Sep 2021 · 1 yr 8 mos

Customer Care Executive at Conneqt Business Solutions, Feb 2019 - Aug 2019 · 7 mos, Managed customer inquiries via email and internal systems Resolved complaints by identifying issues and providing solutions Collaborated with teams to improve service efficiency Maintained accurate records in CRM systems Escalated complex issues for timely resolution

Education

Bachelor of Commerce, Accounting and Finance, Siddhartha Degree College - India

High School Diploma, New Chaitanya Jr college