Headline

Clinical AI | Physician (MBBS, Critical Care) building LLM systems for Claims Adjudication, Prior Authorization & FWA Detection | Prompt Engineering · Medical Necessity Automation

About

Physician-turned-Clinical-AI builder. I design and ship LLM systems that adjudicate health claims — combining 6+ years of bedside medicine with hands-on prompt engineering, model evaluation, and AI workflow design. At Vidal Health, I lead the AI side of claims adjudication and payment integrity: · • Built our fraud, waste & abuse (FWA) detection tool from scratch — now core to payment integrity operations · • Automated prior authorization for physiotherapy end-to-end, removing manual review from the loop · • Drove our AI cost-containment workflow to 99% accuracy through iterative prompt engineering and human-in-the-loop evaluation · • Engineered LMRP medical necessity mapping prompts to >95% accuracy against policy criteria · • Uncovered an additional 2% in claims savings via diagnosis-, provider-, and service-level cost analytics What makes my work different is clinical ground truth. Six years across critical care, cardiac emergencies, ICU ventilator and hemodynamic management, and general practice mean I know what a real chart looks like, what a diagnosis code should map to, and exactly where automation quietly fails. I write the medical logic an LLM can be trusted with — and the evaluation criteria to prove it. MBBS + Fellowship in Critical Care Medicine (Sri Venkateswara Medical College, Tirupati). I'm interested in senior roles at the intersection of medicine and AI — clinical AI development, LLM evaluation and safety, utilization management automation, payment integrity, and clinical informatics. If you're building AI that touches patient care or claims, let's talk.

Location

India

AI stack

antigravity

claude

gemini

openai

claudecode

Work experience

Assistant Manager at Vidal Health, Mar 2025 - Present · 1 yr 8 mos, Bengaluru, • Built our fraud, waste & abuse (FWA) detection tool from scratch — now core to payment integrity operations • Automated prior authorization for physiotherapy end-to-end, removing manual review from the loop • Drove our AI cost-containment workflow to 99% accuracy through iterative prompt engineering and human-in-the-loop evaluation • Engineered LMRP medical necessity mapping prompts to >95% accuracy against policy criteria • Uncovered an additional 2% in claims savings via diagnosis-, provider-, and service-level cost analytics

Medical Doctor at Maven Medical Center, Nov 2021 - Jul 2023 · 1 yr 9 mos, Hyderabad, Telangana, India

Medical Officer at Krishnapatnam Port Company Ltd., Feb 2017 - Mar 2018 · 1 yr 2 mos

Education

MBBS - Bachelor of Medicine and Bachelor of Surgery, Medicine, sri venkateswara medical college