Aniket Shekdar
Senior Business Analyst
Pune
Summary
Aniket has been a Subject Matter Expert on Healthcare Insurance Domain, specializing in Claims Adjudication, Pricing and Payments. Extensive knowledge on Provider Configuration, Provider Contracts/Fee schedules.
Prior to joining CitiusTech, Aniket worked as a Senior Configuration Analyst with a leading Healthcare company. Aniket has completed Bachelors in Computer Science from India. Senior Business Analyst bringing exceptional abilities in competitor analysis, business intelligence development and trend assessment. Successful at promoting company advancements and boosting team performance. Consistently reaches revenue targets by reviewing accurate data and producing creative recommendations.
Overview
7
7
years of professional experience
3
3
years of post-secondary education
Work History
Senior Business Analyst
CitiusTech Healthcare Technology Pvt. Ltd.
Pune
05.2022 - Current
- To successfully promote, acquire, and execute service agreements for its clients, the
- CitiusTech and HealthEdge collaboration built the HealthRules Payor Center of Excellence
- Directed business analysts in executing and delivering various tactical and strategic plans.
- Responsibilities Engaged as Senior Tester in a team and supporting team members with the testing tasks like creating test scenarios and post approval from business, load them in Azure
- Recently, performed functional testing on the “Claims Conversion Utility”, which is developed by HealthEdge with various test scenarios
- Currently, part of BlueCard Home Integration testing where, creating the various test cases/scenarios with the help of the requirements provided in the “Requirement sessions” and BRD
- Also, performed smoke testing on Local Claims (Non-ITS) by executing the test scripts through HRP and gather test results and if needed, raise the defects.
- Recruited new members for business analysis team to support division growth and create strong and productive department, replacing underperforming staff.
- Supported leadership team with reporting, analysis, and business presentations to inform divisional strategies.
Senior Analyst
Evolent Health
Pune
12.2017 - 04.2022
- Led projects as assigned, worked independently & provided test assignments, and status reporting.
- Was responsible to build the test case suite, including test claims, for assigned scope in a timely manner including creation of new test cases linked to business and/or technical requirements; Also, involves selecting existing test assets for execution and to fortify regression testing with minimal guidance.
- Conducted end to end testing including integration points and dependencies.
- Provided configuration subject matter expertise for audit and creation of test plans, test suites, test cases, and testing strategy.
- Ran test claims against designed scenarios to validate results.
- Collaborated with Configuration cross functional areas to develop, implement, and improve testing and auditing processes which support claims processing and proper provider payment.
- Troubleshot and resolved audit and testing barriers or risks. Created test claims, test plans, and test cases.
- Executed end to end test cases for all integration points and dependencies, conducted functional and regression testing.
Process Specialist
Infosys BPM
Pune
01.2017 - 12.2017
- Infosys is a global IT services, consulting and business solutions company delivering best-in-class services and helping worldwide companies to drive business efficiencies., This project involves building benefit plans according to ViewC/Benefit grids into
- ISIC system and auditing cost-shares that were mapped to benefit category
- Main Technologies ISIC Coder, JIRA
- Responsibilities Involved in building group benefit plans and auditing cost-shares Worked with carriers to setup Benefit Configuration in ISIC Assisted in on-going evaluation of configuration for new and existing claims business rules including member benefits, claims editing Analyzed explanation of coverage documents to assist with determining best approach for configuring benefits offered including out-of-pocket and plan maximums
- Was involved in Open Enrolment strategic planning Assisted in set-up of code sets and defining pre-authorization guidelines used in claims configuration to drive application of medical policy and accurate claim payments
- Performed quality assurance checks on transactions and account actions to assess compliance with state and federal regulations.
Education
Bachelor of Science - Computer And Information Sciences
Ramkrishna More College Akurdi
Pune 07.2007 - 08.2010
Skills
Healthcare Standards HIPAAundefined
Timeline
Senior Business Analyst
CitiusTech Healthcare Technology Pvt. Ltd.
05.2022 - Current
Senior Analyst
Evolent Health
12.2017 - 04.2022
Process Specialist
Infosys BPM
01.2017 - 12.2017
Bachelor of Science - Computer And Information Sciences
Ramkrishna More College Akurdi
07.2007 - 08.2010
Similar Profiles
Dhairya KothariDhairya Kothari
Manager - I at US Healthcare - CitiusTech Healthcare Technology Pvt. Ltd.Manager - I at US Healthcare - CitiusTech Healthcare Technology Pvt. Ltd.
Arti Mukherjee SainiArti Mukherjee Saini
Technical Lead at Citiustech Healthcare Technology Pvt LtdTechnical Lead at Citiustech Healthcare Technology Pvt Ltd
Kiran JadhavKiran Jadhav
Technical Lead I Quality Assurance at CitiusTech Healthcare Technology PVT LTDTechnical Lead I Quality Assurance at CitiusTech Healthcare Technology PVT LTD
Abhishek DEYAbhishek DEY
Healthcare Business Analyst at CitiusTech Healthcare Technology Pvt. Ltd.Healthcare Business Analyst at CitiusTech Healthcare Technology Pvt. Ltd.
Aditya SawantAditya Sawant
Sr. Manager Network Operations at Vitech Systems Asia Pvt Ltd.Sr. Manager Network Operations at Vitech Systems Asia Pvt Ltd.