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Ravi Teja - Healthcare Data Analyst

[email protected]

Location: Mountain View, California, USA

Relocation: Hybrid/Onsite inside state or Remote

Visa: H4EAD

R. Teja Business Data Analyst Visa Status: H4EAD Current Location: California Relocation: No Contact: 571 751 1099 https://www.linkedin.com/in/teja-y-659717293/ Summary: Over 9+ years of experience as a Business Data Analyst in project management, system designing, implementation and quality assurance of client business applications with the knowledge of Software Development and Quality Assurance Life Cycle. Experienced with Medicare and Healthcare Insurance as well as Medical Standards HIPAA and HL7. Excellent Knowledge of Electronic Medical Record (EMR) / Electronic Health Records (EHR) modules and process flow. Experienced working with clients in the Healthcare industry. (NPI, Membership & Billing, Meta Vance, EDI 837, Professional and Institutional Claim Processing, COB, NASCO). Proficient in ICD - 9-CM and ICD-10-CM coding and claims processing. Experience working with RDBMS including Oracle/ DB2, SQL Server, Postgres SQL, MS Access and Teradata for faster access to data on HDFS. Exposure to implementation and operations of data governance, data strategy, data management. Experienced in data integration, Metadata management, ETL, Data Modeling tool sets. Experienced working on a large volume of Data using Teradata SQL and BASE SAS programming. Strong knowledge of Unified Modeling Language (UML), and System Development Life Cycle (SDLC) methodologies like Waterfall and Agile/SCRUM. Experience in Data Mining, Data mapping, and Data Modeling and a good understanding of the ETL tools like AB Initio, SSIS, and Informatica Power Center. Technical Skills Business Skills: Rational Unified Process (RUP), Agile/Scrum methodologies, Business Requirement Document (BRD), Business Process Analysis & Design, UML, GAP Analysis, Workflow, Dataflow, Entity-Relationship Diagrams (ERD), UCD, DFD, Impact Analysis, JAD session, Sales force. Software Packages: MS Office (Word, Advanced Excel, Access, PowerPoint, MS Project, MS Outlook), Visual Studio, MATLAB, SharePoint, Quick Sight. Databases: SQL Server, Oracle, and DB2 Business Intelligence Tools: Power BI, Al teryx 9.x, SSIS, SSAS, Tableau 8.x, 9.x, 10.x, Congo s, TIBCO Spot fire Programming Languages: C, C++, SQL, Oracle, Java, Python, AML Language Web Languages: HTML, XML Data Visualization & Reporting: SSRS, Tableau, R Studio Cardinal Health, CA Sr. Business System Analyst/Data Analyst Dec 2021 Till Now Responsibilities: Worked for the Business and System support for the development and maintenance of Web Portal Solutions and Enhancement of Data Warehouse objectives. Performed GAP analysis between the current and TO-BE business process models to determine what additional functionalities are needed to meet HER standards. EMR, EHR, HL7, and electronic data interchange (EDI). Researched the existing client processes and guided the teams in aligning with the HIPAA rules and regulations for the systems for all the EDI transaction sets. Converted HL7 to FHIR Resources for Interoperability goals across systems. Worked in Healthcare Claims Administration Healthcare Claims Processing 837/835 includes facility claims and professional claims. Worked extensively with developing business rules engine enabling the business rules such as referral, prior authorization, eligibility, claims processing and billing essential. Created Project Plan, Project Charter, Business Requirement Documents (BRD s), System Requirement Documents (SRD s), Process flows, data models and Use Cases according to the requirements. Created various data quality mappings in the Informatics Data Quality (IDQ) tool and imported them into Informatica Power Center as mappings. Reporting tools, software, and other applications, including SQL Database, Looker, Tableau and Sales force dashboards (reports designing tool) and Data warehouse. Created various data quality mappings in the Informatics Data Quality (IDQ) tool and imported them into Informatica Power Center as mappings. Agile and Waterfall methodologies were present and identified deficiencies, created a defined business case, and upon approval, implemented strategies for the department and adjacent teams. Involved in testing the SQL, Look ML in Looker & and Snowflake DB Scripts. Outstanding preeminence in Data extraction, Data cleaning, Data Loading, Statistical Data Analysis, Exploratory Data Analysis, Data Wrangling, and Predictive Modeling using R, Data mapping, and Python. Create automated solutions using Data bricks, Spark, Python, Snowflake, HTML. Extensively involved in Data Extraction, Transformation, and Loading (ETL process) from XML to the staging area and from Staging to ODS using Informatica Power Center. Environment: Quality Center, Oracle, SQL, ETL, Informatica, BI Dashboards, Business Objects Report, SharePoint, MS Visio, MS Office Suite, Clear Quest. Molina Healthcare, CA Business System Analyst Aug 2019 Oct 2021 Responsibilities: - Conducted the role of Business Analyst and Senior Quality Analyst for the Health Insurance Marketplace Eligibility & Enrolment project. Used Electronic Medical Record (EMR) to extract useful information regarding patients for claim submission to the insurance company. Modification and creation of EHR content as prescribed by the project team and clinical users. Coordinate with Health Insurance Exchange (HIX) program staff and other stakeholders to define and develop requirements for correspondence generation across various business lines. Analyzed HIPAA 4010 and HIPAA 5010 standards for 837P, 837I, and 835 transactions and prepared a gap analysis document for each transaction. Develop code related to SQL in Snowflake, Teradata, Python and Shell scripting as per the changing needs of the projects for file transfer and automation. Developed dashboard prototypes using Cloud Dashboard Tools Looker and AWS Quick Sight managing all aspects of the technical development. Writing various scripts to query several networking devices, and databases to gather information and store that data in MySQL, Mem SQL and No SQL databases. Involved in specifying the star schema design by applying Data warehouse methodology of dimensional modeling and development using BO Designer. Well versed with Data Migration, Data Conversions, and Data Extraction/ Transformation/Loading (ETL) using DTS, PL\SQL Scripts. Extensively used ETL methodology for supporting data extraction, transformations, and loading processing, in a complex EDW using Informatica. Worked on SSMS and wrote stored procedures and advanced SQL Queries. Extensively worked on Data mapping and created Data Dictionaries. Environment: MS Office, MS Excel, MS SharePoint, ALM, Rally, Agile, Software Development Life Cycle (SDLC), HIPAA 5010, EDI. Humana, KY Data Analyst March 2018 May 2019 Responsibilities: - Involved with all the phases of Software Development Life Cycle (SDLC) methodologies throughout the project life cycle which involved gathering, analysis and documenting business and technical requirements from both formal and informal sessions. Assisted JAD sessions to identify the business flows and determine whether any current or proposed systems are impacted by the EDI X12 Transaction, Code set and Identifier aspects of HIPAA. Mentored business analysts in methodology for defining ICD-10 mapping processes and documenting business requirements. Analyzed data lineage processes to identify vulnerable data points, control gaps, data quality issues, and overall lack of data governance. Used JIRA to track bugs and issues and complete functional tasks. Primarily involved in Data Migration using SQL, SQL Azure, Azure Storage, Azure Data Factory, SSIS, and PowerShell. Utilized corporation developed Agile SDLC methodology. Used Scrum Work Pro and Microsoft Office software to perform required job functions. Coordinates and facilitates work sessions with Medicare Operations users and IT development to define projects' scope and requirements and manage project expectations. Created processes to load data from Azure Storage blob to Azure SQL, to load from web API to Azure SQL and scheduled web jobs for daily loads. Used various sources to pull data into Power BI such as SQL Server, SAP BW, Oracle, SQL Azure etc. Worked extensively through Agile development methodology by dividing the application into iterations. Designs and develops the logical and physical data models to support the Data Marts and the Data Warehouse Developed and documented Data Mappings/Transformations, and Informatica sessions as per the business requirement. Environment: Microsoft Office Suite, Microsoft Visio, Document, COBOL, DB2, SAS/ACCESS, SSIS, SSRS, SSAS, SPSS, Windows NT/XP, UNIX, Oracle, SQL, SQL Server, Sybase, DB2, EVPN, ACORD, XML, Business Objects, Test Director, Load Runner. Care Health Insurance, India Analyst Jan 2014 to Feb 2015 Responsibilities: Ensure billing accuracy for Medicare, Medicaid, and third-party insurance by adhering to EDI X12 standards. Provide Medicare Operations support and deliver standardized data and reporting to meet business user needs. Maintain data integrity through SQL queries, collaboration with the development team, and effective communication using UML-based feasibility studies and Use Case Models. Involved in Guide wire Corporate Training on Guide wire Policy Center, Worked on Commercial Lines Property and Casualty Insurance. Integrate and manage electronic medical records (EMR), electronic health records (EHR), personal health records (PHR), and patient medical records (PMR) using ASP technology and full integration tools. Environment: Crystal Reports XI/XI R2, SAS v9.0, SPSS, SSIS, SSRS, SSAS, DB2, RUP, UAT, OBIEE, COBOL, GAD Gap Analysis Document, Microsoft Office 2007 Professional Outlook, Word, Excel, Visio, Access, Microsoft SharePoint 2007. Education: MSc Biotechnology (Dr. V. S. Krishna govt college/Andhra University and May 2008) Keywords: cprogramm cplusplus machine learning business intelligence database rlang information technology business works microsoft procedural language Alabama California Kentucky