At Optum, I own out-of-network reimbursement analytics for payer and provider clients. I build SQL queries and Power BI dashboards to track payment discrepancies, arbitration cases, reimbursement recovery, and denial-to-appeal cycle time.
I reduced manual reconciliation effort by 25% by automating payment variance reporting with Power Query and Excel. I also develop validation scripts and exception reports that flag claim pricing discrepancies for arbitration review.
At Mphasis, I delivered revenue cycle analytics for a healthcare provider client, building Tableau dashboards and Alteryx workflows to track reimbursement and denials. Earlier, at Centene, I analyzed Medicaid and Medicare claims and identified authorization-related denial trends that prompted a change to the prior authorization review workflow.
