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Amit Mishra

@amitmishra25

Business Analyst & Product Manage with 17+ years in healthcare claims and RCM Kept a 100M claim platform at 97% first-pass then built AI-driven automa

United States

Message

What I'm looking for

I'm looking for healthcare technology work where I can lead discovery, translate data and workflow complexity into build-ready requirements, and partner with product, engineering, QA, and business teams through UAT and launch.

I've spent the last 17+ years working inside U.S. healthcare IT, on the payer, provider, and healthcare technology vendor side, mostly around claims and revenue cycle systems. I started as a delivery engineer supporting MetaVance, a claims adjudication engine, learning from the ground up how claims move through eligibility checks, benefit edits, and adjudication before they're paid or denied. From there I moved into business analysis and project management at Allscripts, owning requirements for PayerPath, an RCM platform processing over 100 million claims a year for 5,000+ providers, where I helped keep claims quality at 98% and first-pass rate at 97%.

Since then I've grown into Product Owner and Program Manager work, most recently at Sutherland, where I built SmartCred, a provider credentialing platform, and an automated claims-appeal engine that's now used across multiple client accounts. Today I lead product ownership for a MedTech Radiology client, applying AI to speed up requirements, documentation, and workflow automation for a Radiology Information System and a new Patient Portal.

What I'm looking for next is a role that keeps me close to healthcare claims and RCM domain work while continuing to grow into AI-driven product delivery. I hold an H-1B visa and can start immediately, I'm open to relocating anywhere in the U.S., and I'm looking for on-site or hybrid roles. I'm PRINCE2, PRINCE2 Agile, and Certified ScrumMaster credentialed, currently based in Boca Raton, FL.

Experience

Work history, roles, and key accomplishments

Current

Healthcare Business System Analyst

Current

Sutherland Global Services, Inc.

Aug 2021 - Present (5 years 1 month)

Serves as lead business analyst across healthcare provider and payer initiatives, conducting business discovery and documenting technical specifications. Applies AI-assisted prompt engineering to draft compliance documentation and drive requirements through UAT.

SQL Snowflake Oracle Data Warehouse Power BI Tableau Excel Jira Azure DevOps Prompt Engineering Claude HIPAA RCM Claims Adjudication X12 Provider Credentialing UAT Agile Scrum

Associate Project Manager

Huron

May 2020 - Jul 2021 (1 year 2 months)

Coordinated requirements and delivery across a 20-person team, managing backlog, risk register, and scope for a portfolio of client engagements. Facilitated sprint planning, demos, and retrospectives while working with client executives to lock down scope and requirements.

Project Management Azure DevOps Backlog Management Risk Management Sprint Planning Agile Scrum Onshore Offshore Coordination Stakeholder Management

Healthcare Consultant

CitiusTech Inc.

May 2019 - Jun 2020 (1 year 1 month)

Analyzed existing systems and workflows for a CRO/life sciences client, identifying process gaps that shaped the design of a new business intelligence solution. Authored RFP responses and solution proposals, defining solution architecture and execution plans built around data lake and data warehousing concepts.

Business Analysis Data Warehouse Data Lake RFP Solutions Architect Pre Sales SOW Healthcare IT Clinical Trial Management

Expert Business Analyst

Allscripts Healthcare Solutions

May 2011 - May 2019 (8 years)

Owned end-to-end RCM workflow requirements for PayerPath, a platform processing over 100 million annual claims transactions. Served as subject matter expert on X12 EDI transactions, SQL-based data analysis, SOX audits, and HIPAA compliance, maintaining 98% product delivery quality and 97% claims first-pass rate.

SQL Excel X12 837 835 RCM Claims Adjudication HIPAA SOX ICD 10 CPT HCPCS ServiceNow Agile Scrum Requirements Analysis Data Analysis

Delivery Software Engineer

Mphasis

Sep 2008 - Jan 2011 (2 years 4 months)

Worked on MetaVance, a claims adjudication engine, supporting requirements and testing across core administration modules and X12 EDI transaction validation. Delivered healthcare domain training sessions to development teams.