At Centene, I analyze out-of-network claims reimbursement and denial trends, building Power BI dashboards that surface arbitration-eligible claim patterns for operations leadership. I also reconcile EDI 835 remittance data against 837 claim submissions to flag reimbursement discrepancies.
I automated recurring reimbursement reconciliation reports with Python and Pandas, reducing manual reporting effort by 25%. My work also tracks denial, appeal, and prior authorization turnaround metrics across provider groups.
At Wipro, I delivered revenue cycle analytics for a healthcare payer client, including Tableau dashboards for claims reimbursement, denial rates, and out-of-network cost trends. I developed validation scripts and source-to-target mappings that improved data accuracy by 20%.
Earlier, at Capgemini, I analyzed claims and reimbursement data for a healthcare provider client and developed SSIS packages for reporting marts. I also identified a spike in authorization-related rejections and produced an exception summary that prompted operations to revise the prior authorization review workflow.
