Highly-skilled software development professional bringing more than 10 years in
software development and configuration using EPIC Tapestry. Experienced working in claims processing and managed care systems and well versed in all the stages of development cycle. Advanced knowledge of Tapestry system in contracts, fee schedules, EDI batch type definitions, AP claims and CRM process.
EPIC Tapestry core
EPIC Tapestry AP claims & contracts
Service Management Suite
Technical specifications creation
Excellent problem-solving abilities
EPIC Certified in Tapestry core
EPIC Certified in Tapestry AP claims & contracts
IBM certified in Datastage Enterprise Edition 7.5
MastechSenior Systems Analyst - Tapestry | Kaiser Permanente, Pleasanton, CA | January 2015 - Current
Built provider contracts with proper Tapestry functions which includes components, component group, fee-schedules, buckets, conversion factor, pricing extension, whole claim component group, fee-schedule map and EOB codes. Developed complex rules using pricing extensions to invoke and apply the business rules.
Analyzed provider contracts to determine the best approach for loading data elements into
the claims processing system.
Developed, drafted and executed test plans for configuration testing and validated the
accuracy of loaded data.
Coordinated with system partners to finalize designs and confirm requirements.
Consistently met the deadlines for all the production work orders.
Proposed technically feasible solutions for new functional designs and suggested options for performance improvement.
Worked closely with the stakeholders to review and assess the claim processes and coordinated on critical deliverables.
Enhanced the reusability of the contracts by creating and deploying shared roll-up
Good knowledge in EDI batch type definitions.
Tracked the production issues through CRM process and provided update or fix to
get it to closure.
Well versed in importing and exporting the master files through chronicles.
Expertise in Provider (SER), Vendor (VEN) and Place of service (EAF) record linkages.
Validated the migration between source and target environments using macros and identified the discrepancies to be fixed.
AccentureAssociate Manager | Kaiser Permanente, Pleasanton, CA | September 2006 - January 2015
Conducted preliminary evaluation of contractual agreement prior to execution so as to determine the system configurability.
Interpreted the end user requirements by completely discussing the potential options and helped the client move towards an optimal solution.
Provided documentation on first level troubleshooting of processes to help the desk staff.
Supervised and provided direction for nine technical direct reports regarding configuration activities.
Managed change requests including level of effort, cost estimation, build documentation and user training.
Recommended process improvements, design solutions and integration solutions.
WIPRO TechnologiesSoftware Engineer | Target, Chennai, India | September 2005 - September 2006
Responsible for gathering the requirements, performing impact analysis and preparing
Designed and implemented new standards for core business services.
Master of Computer ApplicationsIGNOU UniversityNew Delhi, India | 2010
Bachelor of ScienceComputer ScienceBharathiar UniversityCoimbatore, India | 2005