Karimullah Mastan

Gather and analyze business, functional, and regulatory requirements for healthcare payer initiatives involving Medicare, Medicaid, member enrollment, eligibility, claims processing, and operational workflows. Translate findings into BRDs, functional specifications, user stories, acceptance criteria, and requirements traceability matrices.

Led requirements discovery sessions with patient access, revenue cycle, billing, finance, clinical operations, and IT stakeholders. Analyzed end-to-end hospital revenue cycle workflows including patient registration, insurance eligibility verification, prior authorization, charge capture, claims submission, remittance processing, denial management, accounts receivable, and payment reconciliation.

Partnered with healthcare payer operations, product owners, provider services, compliance, and technology teams to elicit, analyze, and document requirements for claims processing, member eligibility, provider data management, and healthcare system enhancements. Developed BRDs, functional specifications, epics, user stories, acceptance criteria, and process flows to support system modernization.

Collaborated with healthcare business, operations, and technology stakeholders to gather and document business requirements for member account management, billing workflows, enrollment and eligibility processes, payer coordination, and operational reporting. Facilitated stakeholder workshops and developed BRDs, functional requirements, business rules, process flows, and acceptance criteria.

Studied Computer Science and Engineering at Jawaharlal Nehru Technological University Hyderabad.