Experience

Gastrointestinal Associates, Inc.

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Health application analyst

  • Jan 2021 - Present

  Prior Authorization Specialist using EPIC software with hands on experiment in coding and closely monitor authorization process for the practice, with a special focus on the clarity of each module. Proven experience in providing support to medical personnel during EMR implementations. Handling precertification authorization for outpatient cases and assigning referrals as per insurance using EPIC software. Prior Authorization Specialist using EPIC software with hands on experiment in coding and closely monitor authorization process for the practice, with a special focus on the clarity of each module. Proven experience in providing support to medical personnel during EMR implementations. Handling precertification authorization for outpatient cases and assigning referrals as per insurance using EPIC software.



AmeriHealth Caritas

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Utilization Management Tech

  • Oct 2020 - Mar 2021

  Executed a multi-faceted and all-encompassing role, liaising with company leadership to promote a culture of continuous improvements while supporting decision-making for deploying process optimization and operational excellence roadmaps, methods, and tools across the enterprise. Served as a main contributor, conceptualizing, designing, developing, and deploying robust and state-of-the-art applications and systems to support utilization and authorization activities. Executed a multi-faceted and all-encompassing role, liaising with company leadership to promote a culture of continuous improvements while supporting decision-making for deploying process optimization and operational excellence roadmaps, methods, and tools across the enterprise. Served as a main contributor, conceptualizing, designing, developing, and deploying robust and state-of-the-art applications and systems to support utilization and authorization activities.



Accenture

• Ireland
• Business Consulting and Services
• 700 & Above Employee

• Accenture Consultant

  • Sep 2015 - Aug 2019

  The application enables to transform Customer service experience for healthcare in the CRM platform to drive higher customer satisfaction & efficiency across operation. The scope of this program is to enable systematic data integration with various Cisco systems to enhance overall automation and improve average handle time for service request. My contribution was to develop a generic framework that enables the leading medical insurance to ease the process of onboarding new entities like providers, claims, system and data involved in a health care management process. In a typical case, a verity of tasks can be automated including workflow management, generation of alert and patient /member correspondence while retrieving data from or writing data to existing system. Show less