A. E. Vishnupriya

• Developed data-driven process insights and actions utilising Celonis software collaborated with clients uncover process inefficiencies and understand the root causes
• Conducted business process analysis and identified critical issues, gaps, and need for an established Process Explorer
• Developed action plans to mitigate risks in decision making while converting static file to dynamic in Business Module
• Created analysis, enhanced functions and procedures, data gathering and interpreted business requirements into Celonis analysis

Worked on Business Process Reengineering in Health Care Sector with prime focus on Membership, claims adjudication, migration, provider, eligibility, and prior authorization for Medicaid and Medicare programs and commercial products.

Developed and implemented ~ 25 projects on enrolment, claims processing, generating member correspondence, provider load, membership and billing reconciliation with CMS and state for Medicare and Medicaid LOB’s, reports generation, creating Facets interface extensions using xcoms, integrating Facets with vendor system both real time integration using FXI as well as Batch integration.

Reduced the time to Production for critical problem fixes and new application development by 60% by planning & implementing new processes. Resulted in increased number of annual defect resolution.

• worked with Dental Faces team to develop reports that need to be shared with government and also was part of a critical project to intake and edit the eligibility files from all third party vendors.
• Worked with software development and testing team members to design and develop robust solutions to meet Project for functionality, scalability, and performance.
• Coordinated with other engineers to evaluate and improve software interfaces.

• Joined as Fresher and worked with Senior facets team to improve the Provider matching logic on claims which has increased the Claims first pass rate from 60% to 85%
• Also worked on migrating the Facets system as part of company wide platform optimisation .