Basic SQL
MANU VIKRANT
Panchkula
Summary
Diligent Product Owner/Specialist with solid background in US Healthcare product development and stakeholder management. Successfully led cross-functional teams to deliver high-impact RCM and other Healthcare products aligned with business goals helping both Payor and Provider clientele. Demonstrated expertise in agile methodologies and effective communication and collaboration with diverse teams.
Overview
18
18
years of professional experience
4
4
years of post-secondary education
3
3
Certifications
Work History
Consultant – Independent Capacity
Independent Contractor
Panchkula, Mohali
07.2024 - Current
- Agile methodology for development of in-house rule engine product and analytics products/features.
- Creating and maintaining BA artifacts like BRD and FRD, writing user Stories to convert requirements into features.
- Maintaining backlog with an eye on product competitiveness and conducting stakeholder interviews.
- Conducting research on current guidelines and updates for existing clients in operations and onboarding of new clients or client trials.
- Collaborated with cross-functional teams in operations, technical team, business development team, and automation team to successfully deliver comprehensive solutions for clients.
- Managed client relationships through regular check-ins and updates on project progress in operations, Automation and product teams.
- Liaised with customers, management, and sales team to better understand customer needs and recommend appropriate solutions.
- Identified areas of improvement in medical coding and billing practices for in-house clients through quality checks and audits as well writing rebuttals for client queries.
- Conducted thorough market research and analysis, providing valuable insights for client decision-making for product team.
- On ground support for medical coding team on ad-hoc basis for chart based coding.
Manager - Business Analysis
Perceptiviti Data Solutions Pvt Ltd
Gurgaon
04.2021 - 02.2024
- Utilizing Agile methodology for development of Rule-Engine based products and in-house analytics products/features
- Creating and maintaining BA artifacts like BRD and FRD, writing user Stories to convert requirements into features
- Utilizing Scrum framework and conducting stakeholder interviews for discovery and refinement of business needs, backlog ownership, tracking tasks and subtasks to completion according to definition of done
- Attending and leading sprint events like DSM for feature development and resource utilization, review and retrospection associated with sprint lifecycle
- Client interaction and discussions regarding requirement gathering and elicitation, gap analysis, feedback and enhancements
- Internal discussions including stakeholder interviews and with tech team for Definition of Done, coordinate with tech leads/scrum masters for task creation, change and tracking using tools like Jira and Clickup; tracking progress via Kanban boards, using wireframes to convey logic and output from edits
- Maintaining related artifacts like product backlog, Kanban tasks for business team (user stories), business requirement documentations as needed, MOMs and other client communication for product feature meetings, pseudocode matrix, creation of user acceptance testing scenarios, client feedback and engagement for product enhancement
- Leading product features for rule-engine based product; responsible for life-cycle of edits including research, masterdata compilation, masterdata mapping; lead discovery, creation and acceptance of business rules from medical coding research and client policies into actionable edits
- Strategic decision discussions like Product conceptualization, Go to market initiatives including product packaging, product discovery, market research for competing products, product design features like defining LOBs, specialties, provider types, etc; involvement in answering Post-sales RFPs questionnaire and client-facing decks for capability demonstration
- Team collaboration for OKR achievement, Understanding stakeholder and client requirements, collaboration with team and stakeholders for requirement analysis and feature development
- Successful onboarding of two new clients during my tenure while helping the technical and sales with the RFPs, demo and first pass of our product. Successfully collaborated with client for their issues and necessary rebuttals on product features and output.
- Single handedly developed and collaborated with the tech team for implementation of rule engine logic for more than 70% of product IP responsible for anywhere between 30 to 80% of product output directly deliverable to the client.
Business Systems Analysis Sr. Specialist
NTT Data Pvt Ltd
Noida
06.2018 - 03.2021
- Engaged in Prepay claim scrubbing product and Recovery analytics for payers and providers, mainly providing functional BA and domain expertise
- Maintaining BRD documentation, collaborating with cross functional teams for POCs, RFPs, and client facing decks with scenario examples
- Acting as domain expert for the team, suggesting and leading initiatives on domain specific feature enhancements in Payment Integrity product and rule engine
- Single-handedly developed logic for CMS-based rules contributing to around 50% of output for the Payment Integrity product on the rule-engine aspect.
- Successfully leveraged domain expertise to transform a legacy application to Azure based application for one of the major payor client by deriving updated logic and collaborating with technical team for the development and implementation of same.
- Involved in RFP responses for the domain specific aspects.
- Developed scenarios for client facing demo and presentation decks that clearly brought out prime use cases for our Payment Integrity product.
Claims Quality Analyst (Product Research Analyst)
Optum (formerly UnitedHealth Group)
Noida
01.2014 - 06.2018
- Worked as Product Research Analyst (Claims Quality Analyst) in Medicaid Data Development team for a reimbursement-driven rules-based engine to help clients scrutinize their claims
- Profile primarily involved product research and development based on secondary research from secondary and tertiary resources in Medicaid Reimbursement and medical policies involving various programs and different provider provisions in Medicaid
- Use of SQL-based rule development engine to develop rules utilizing logical parameters (operators, operands, lists, values, etc) for a claim processing product; including development of claim testing scenarios, building product edits around real-time claim scenarios, validating rules for Coding guidelines and Medicaid policies
- Provided support in client queries and rebuttals as well as independent handling of direct queries, collaborating with team members for rebuttals, rationale and research
- User story creation and updation in Kanban boards using Rally tool
- Cleared Management Trainee assessment including Aptitude round and Behavioral Assessment round (third party evaluation by PWC)
- Attended trainings on various soft skills and US Healthcare concepts, .e.g
- Messaging and Presentation Skills, Problem Solving, Situational leadership, Healthcare Insurance Exchange, etc
Coding Content Writer
Eli Research Pvt Ltd.
Faridabad
10.2013 - 01.2014
- Worked as Coding Content Writer
- Responsible for writing content for digital and online coding content for CPT lay terms in accordance with AMA defined procedural concepts
- The process required extensive research into various CPTs in terms of their reporting guidelines and service coverage so that coding professionals can use that content to guide their coding scenarios
- As a Coding Content Writer, the profile included providing content writing for marketing team including development of LPs for coding products like data sets
- Also coding content development for books, journals, quizzes, etc
- The profile also included working as part of a coding/billing experts’ team on online forums responding to queries from customers to provide authentic, result-oriented solutions within a 24-hour TAT on various coding billing questions
Team Lead (Medical Coding)
One World Technologies Pvt Ltd.
Ambala
03.2013 - 10.2013
- Worked as Team Lead (Medical Coding)
- Responsible for process development including development and upkeep of guidelines, direct interaction with client offices for coordination of process streamlining
- Serve as a central knowledge base for all aspects as required in coding and related billing aspects like chargemaster, claim rejections, superbill creation, etc
- Also, been involved in the Certification process for Meaningful Use certification of the proprietary EHR of our company
- Direct reporting to the Organisational Head (CEO) and also coordinate and report to the client base in US (the Joint Venture)
- Involved in hiring process and responsible for spearheading future expansion including training
Sr. Medical Coder
IDS Infotech Ltd.
Mohali
10.2011 - 03.2013
- Responsible for process development, guidelines and serve as a central knowledge base for specialty coding projects involving E&M, surgery coding, and HCC Coding
- Also, conducted training for ICD-9 CM and HCPCS coding skills for coding trainees and also actively involved in the recruitment process by coordinating with the HR department and Process Manager for the same
Medical Coder
Genascis India Pvt. Ltd.
Noida
04.2007 - 08.2011
- Started the Medical Coding career as a Trainee and working as Medical Coder 1, Grade B, and then as Grade A with 90% of work volume as client-deliverable
- Project initiative and development of internal guidelines with data research for HCPCS Level II codes from CMS, AMA and other online resources
- Worked as an Independent Contractor (WFH) with GPM delivering more than 95% of work volume directly to the client and responsible for day-end and month-end reporting and client-end communication for issues
Education
MBA - Healthcare
02.2018 - 11.2021
- Passed in 2023
- GPA: Overall Grade B
Skills
Problem-solving
Team collaboration
Client relationships
Client rebuttals
Stakeholder Interviews
Best practices implementation
Requirements gathering
Market research and analysis
Secondary research
US Healthcare RCM
Medical Coding and billing
US Healthcare statutes and guidelines
Medicare, Medicaid, Payor guidelines and practices
Fraud Waste and Abuse analytics
Claims Analytics
Business analysis
Certification
Certified Professional Coder from AAPC.
Personal Information
- Gender: Male
- Nationality: Indian
- Marital Status: Married
Software
Basic Python
Timeline
Consultant – Independent Capacity - Independent Contractor
07.2024 - Current
Manager - Business Analysis - Perceptiviti Data Solutions Pvt Ltd
04.2021 - 02.2024
Business Systems Analysis Sr. Specialist - NTT Data Pvt Ltd
06.2018 - 03.2021
Sikkim Manipal University - MBA, Healthcare
02.2018 - 11.2021
Claims Quality Analyst (Product Research Analyst) - Optum (formerly UnitedHealth Group)
01.2014 - 06.2018
Coding Content Writer - Eli Research Pvt Ltd.
10.2013 - 01.2014
Team Lead (Medical Coding) - One World Technologies Pvt Ltd.
03.2013 - 10.2013
Sr. Medical Coder - IDS Infotech Ltd.
10.2011 - 03.2013
Medical Coder - Genascis India Pvt. Ltd.
04.2007 - 08.2011