Girish Mallegowda

• Worked as a senior BA and scrum master for a product team, coordinating project initiatives with software developers, stakeholders, project managers and testers.
• Acted as a liaison between functional business units and development team, eliciting and documenting business requirements from SMEs by writing user stories.
• Created and managed product backlog, sprint backlog and user stories, ensuring clarity, completeness and alignment with project deliverables.
• Conducted sprint planning, daily scrums, retrospectives and sprint demo, working with the team to identify capacity and set realistic sprint objectives.
• Guided the development teams to break down large and complex user stories into simplified versions for execution.
• Tested the user stories for accuracy and compliance, ensuring undisputed acceptance and validation of stories.
• Identified and prioritized the common causes of defects, and systematically removed them to prevent reoccurrence in further development work.

Client: Finvi and CVS Health

• Gathered and documented functional requirements (URS and FRS) and created User Stories based on the features.
• Utilized systematic techniques like use-case scenarios, process modeling, and data-flow diagramming to ensure comprehensive requirements, considering product feasibility and market needs.
• Collaborated with cross-functional teams to ensure the system design aligned with business objectives and user needs.
• Coordinated with the UX design team to create product design and ensured user-centric design decisions.
• Utilizing JIRA for project management and tracking
  Contributing to strategic planning initiatives
• Developed business process models to identify and document customer requirements.

Client: Optum Inc

• Reviewed and analyzed paid health insurance claims for payment integrity, contract compliance, coverage validity, and quality assurance.
• Investigated already paid claims for duplicate payments and health insurance fraud, waste and abuse.
• Conducted user acceptance testing for new tools and assisted the business team in developing new algorithms.
• Acted as the point of contact between the business units and IT, effectively bridging communication gaps and ensuring alignment between stakeholders

Client: Aetna Inc

• Verified, paid, denied and adjudicated healthcare claims for a leading US health insurance company.
• Processed physician and facility claims with extensive experience and good understanding of medical terms, benefit determination, co-ordination of benefits, Medicare and Medicaid claims.
• Maintained high quality and productivity standards, and processed claims as per the required TAT.
• Trained new hires on adjudication process and standard procedure.
• Received recognition for outstanding performance, customer satisfaction, and error-free claims processing