Bangaru Janaki

Project aims to implement a modern, scalable and flexible encounter submission system using cloud technologies, aimed at ensuring timely submission and acceptance of Medicare Encounters to CMS. The objective is to streaming claims processing and facilitate timely reimbursement from CMS to Humana.

Responsibilities:

• Executed SQL queries to aggregate and transform data from sources such as CSV, Excel, JSON and PARQUET ensuring data accuracy and integrity.
• Involved in the creation and implementation of a reliable data pipeline for automated ETL procedures utilizing Python and Azure Data Factory, enabling quicker data processing and analysis.
• Designed and implemented advanced data copying rules in Azure Data Lake Storage, resulting in a significant reduction data duplication and enhanced data quality.
• Orchestrated and monitored data pipelines meticulously to guarantee precise and timely data processing, ensuring project objectives were consistently met.
• Played a significant part in improving the overall efficiency and success of the project by lowering the encounter claim failure percentage through efficient data processing and pipeline optimization.

This application is a Digitized platform to assess production support engagements across
production support areas, baseline the level of operations excellence, and empower the operations team to self-assess and generate the report with levels, recommendations, and risks automatically.

Responsibilities :

• Implemented core functionalities in Python, writing clean, maintainable, and modular code to serve as the backbone of the application.
• Designed and executed SQL queries to validate and process assessment data, ensuring data accuracy and reliability throughout the reporting process.
• Built an automated reporting engine that generated self-assessment reports with risk indicators, recommendations, and operational excellence levels for stakeholders.
• Performed debugging and root cause analysis, fixing critical issues to improve application stability and performance.
• Collaborated with the operations team to capture requirements and deliver actionable insights aligned with production support objectives.