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Sameer TokeST
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Sameer Toke

@sameertoke

Healthcare Claims Testing Analyst at Evolent Health who automated reconciliation reporting, reducing turnaround from days to minutes.

India
Message

At Evolent Health International Pvt. Ltd., I built UAT and QA validation plans and tested end-to-end claims payment workflows across payer client accounts. I also wrote SQL queries that cut manual data-preparation time by about 30%.

I gathered client requirements and translated financial discrepancies into test scenarios, configuration fixes, and reporting improvements. I documented defects in Jira, Pareo, and MPX and worked with client, business, and technical teams through resolution and retesting.

At Infosys BPM Ltd., I audited and processed Medicare appeals under CMS guidelines and served as a subject matter expert for appeals and claims-processing queries. I also mentored junior staff and led new-hire training.

Earlier, at Syntel India Ltd. and TriZetto India Pvt. Ltd., I supported healthcare system QA, claims testing, processing, and validation. My work included testing corrected-claim adjustments and verifying pricing and payment accuracy.

Experience

Work history, roles, and key accomplishments

EL

Senior Analyst – Claims Payment Integrity

Evolent Health International Pvt. Ltd.

Sep 2021 - Jan 2026 (4 years 4 months)

Built UAT and QA validation plans and test scenarios for system changes, validated end-to-end claims payment workflows across six payer clients, and wrote SQL queries to validate high-volume claims data. Developed Power BI dashboards to automate reconciliation reporting.

Education

Degrees, certifications, and relevant coursework

MC

Maharashtra College of Science & Commerce

Bachelor of Computer Applications, Computer Applications

Bachelor of Computer Applications degree from Maharashtra College of Science & Commerce, Pune.

MI

Microsoft

Power BI Desktop, Power BI Desktop

Completed Power BI Desktop certification through Microsoft / Udemy.

UD

Udemy

SQL for Data Analysis, SQL for Data Analysis

Completed SQL for Data Analysis certification through Udemy.

Tech stack

Software and tools used professionally

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