Siri Kariveda

Connected clinical, pharmacy, claims, compliance, care management, IT, and Salesforce teams, translating decisions into user stories, acceptance criteria, and data rules. Mapped 60+ MCG and InterQual decision points into structured fields, cutting data-team tickets by about 30% over two quarters.

Captured requirements for an Rx-savings platform, including pharmacy operations, PBM partners, payer teams, and clinic users. Reconciled 18 months of eligibility, denial, AR-aging, and payment-posting data, surfacing about $22K in underpayments and missed copays.

Performed coding-audit and CDI engagements, reviewing inpatient and outpatient charts against ICD-10-CM, CPT, HCPCS, and CMS rules. Conducted more than 5,000 chart audits over four years, surfacing recurring upcoding, under-coding, and documentation gaps.

Handled pre-operative assessments, treatment planning, surgical extractions, and post-operative follow-up for about 25-30 patients per week. Improved repeat denials by about 20% over six months by addressing missing surgical-site notation and radiograph references.

Completed Generative AI Overview for Project Managers in November 2023.

Completed Fundamentals of Agile Project Management in September 2023.

Activities and societies: Undergraduate clinical research (2015–2016) on periodontal-cardiovascular links and systemic effects of untreated dental infections at Mamatha Hospital, India.

Bachelor of Dental Surgery (BDS) from Kakatiya University, India.

Completed Lean Six Sigma White Belt certification in November 2023.

Grade: 3.9 / 4.0

Activities and societies: Relevant graduate coursework: Clinical Decision Support, Healthcare Data Analytics, HIT Systems and Standards (HL7/FHIR), Healthcare Project Management, and Health Informatics Capstone.

Master of Science in Health Informatics with a GPA of 3.9/4.0.

Completed Machine Learning course in March 2026.

Completed AI for Business and Machine Learning courses in March 2026.