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Karunakar User

@karunakaruser

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Pharmacy Network Analyst at PharmaForce Infosoft who validated claim pricing and tested formulary and network APIs.

India

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At PharmaForce Infosoft Pvt Ltd, I validated pharmacy claims against NCPDP transaction logic and tested benefit plans in UAT. I analyzed reimbursement discrepancies and created reports for management and audit compliance.

I also used SQL to check claim and benefit data, and tested formulary and network API requests in Postman. I partnered with Dev Team and QA to investigate network issues, reproduce defects, and validate fixes.

At Optum Global Solutions (UnitedHealth Group), I tested PBM benefit plans and claims in UAT, conducted quality audits, and prepared reports. Earlier, at Quant Cloud Solutions Pvt Ltd, I supported pharmacy and healthcare data initiatives and investigated RxCLAIM output discrepancies.

Experience

Work history, roles, and key accomplishments

Pharmacy Network Analyst

PharmaForce Infosoft Pvt Ltd

Nov 2023 - Jun 2026 (2 years 7 months)

Validated pharmacy claims against NCPDP transaction logic and resolved reject codes during UAT. Analyzed reimbursement cases, ran SQL queries, and tested API endpoints to ensure accurate claim processing.

NCPDP Claims RxClaim AS 400 SQL Postman UAT Claims Adjudication Reimbursement Analysis Root Cause Analysis SOPs Client Management Reporting

Senior Digital Engineer

Quant Cloud Solutions Pvt Ltd

Aug 2023 - Oct 2023 (2 months)

Supported digital transformation initiatives for pharmacy and healthcare data systems. Analyzed requirements and investigated data discrepancies in RxCLAIM outputs.

RxClaim Data Analysis Salesforce RFC Cross Functional Collaboration

Quality Specialist

Optum Global Solutions

Apr 2018 - Aug 2023 (5 years 4 months)

Performed benefit testing and quality assurance for PBM applications in UAT environments. Conducted CQA audits, resolved claims processing inquiries, and published production performance reports.