Worked as a Business Analyst in the healthcare domain, supporting enrollment, claims processing, and provider data management systems in compliance with HIPAA and CMS guidelines.
Collaborated with cross-functional teams to gather and document requirements for EDI 834 (enrollment) and 837 (claims) transactions. Created BRDs, user stories, and process flows to improve system efficiency and streamline claims adjudication workflows.
Performed data analysis using SQL to identify inconsistencies in eligibility and claims data, and supported data migration and validation efforts during system modernization. Actively participated in Agile ceremonies, UAT coordination, and defect resolution to ensure smooth delivery.
Contributed to process improvements, automation opportunities, and compliance-driven initiatives while supporting integration with external vendors and maintaining data governance standards.