Murali Krishna Doulpalli
Business Analyst
Hyderabad
Summary
Experienced business analyst with 9 years of expertise in the US healthcare industry. Highly skilled in configuring Facets and performing meticulous manual testing to ensure data accuracy through comprehensive data validation techniques. Proficient in conducting in-depth research and leveraging SQL for effective data management and analysis.
A dynamic and results-oriented lead with 7 years of experience in healthcare, with a proven track record in supporting operations, providing team leadership, and delivering excellent customer service. Excels at driving productivity and efficiency through effective staff training and development.
Strong background in medical coding and thorough understanding of healthcare regulations, adept at enhancing operational efficiency and ensuring compliance with industry standards. Proven ability to collaborate with cross-functional teams, driving continuous improvement and delivering high-quality healthcare solutions.
Overview
9
9
years of professional experience
Work History
Business Analyst
CARELON GLOBAL SOLUTION
7 2022 - Current
- Developed comprehensive test plans and test cases based on project requirements and specifications
- Collaborated with stakeholders to define testing objectives, scope, and timelines
- Executed manual test cases to validate software functionality, usability, and performance
- Coordinated UAT activities with business users to validate software against business requirements
- Implemented quality assurance processes to validate configuration changes and updates
- Experience in customizing and maintaining facets configurations for various healthcare Benefits
- Analyzed business requirements and translated them into technical specifications for Facets configuration
- Proficient in using tools like Excel, SQL, Power BI for analyzing healthcare data
- Familiar with techniques like BPMN, use cases, process flows, and user stories.
Associate - Ops
WNS BUSINESS CONSULTING PVT LTD
09.2020 - 06.2022
- Supervise and lead a team of medical coders, providing guidance, support, and performance evaluations
- Ensure accurate and timely coding of medical records, including ICD-10, CPT, and HCPCS codes
- Monitor and review coding quality and accuracy, conducting regular audits and providing feedback for improvement
- Conduct training sessions for new and existing coders
- Develop and implement training programs to enhance coding skills and knowledge
- Ensure adherence to coding guidelines, healthcare regulations, and industry standards
- Stay updated on changes in coding practices and regulations
- Identify areas for process improvement and implement best practices to enhance coding efficiency and accuracy
- Prepare and present reports on team performance, coding accuracy, and productivity to senior management
- Address and resolve any issues or discrepancies related to coding and documentation
- Proficient in data analysis and reporting to support decision-making processes
- Recognized for exceptional leadership and awarded.
Senior Associate
Optum Global Solutions
05.2017 - 02.2020
- Oversee day-to-day operations, ensuring adherence to company policies, procedures, and quality standards
- Identify opportunities for process optimization and implement best practices to enhance efficiency and productivity
- Manage resource allocation, including staffing, equipment, and materials, to ensure operational requirements are met
- Track and analyze key performance indicators (KPIs) and operational metrics
- Prepare and present reports to senior management
- Address and resolve operational issues, challenges, and escalations promptly and effectively
- Conduct training sessions and workshops to ensure team members are equipped with the necessary skills and knowledge
- Ensure compliance with industry regulations, safety standards, and company policies.
Associate
Optum Global Solutions
05.2015 - 05.2017
- Review and evaluate claims to determine eligibility, coverage, and liability
- Ensure that all claims are processed in a timely manner
- Make decisions on claims based on policy guidelines, industry regulations, and investigative findings
- Maintain detailed and accurate records of all claims and related correspondence
- Ensure compliance with company policies, industry standards, and regulatory requirements
- Handle claim disputes and appeals, providing clear explanations and resolutions as needed
- Prepare reports on claims statistics, trends, and potential issues for management review.
Education
Bachelor of Science - Computer Science
Pandit RaviShanker University
Raipur, India 04.2001 -
Skills
Facets Configuration
Quality Assurance and Auditing
Claim Management
SQL and Data Validation
Medical Coding
Rework Claims and Charts
Manual Testing
Relationship and Team building
Denial Management
Accomplishments
- Bronze medal in Commonwealth Karate Championship, South Africa 2009.
- Participated in World Cup in karate Istanbul, Turkey 2010
- Participated in Commonwealth Karate Championship, South Africa 2018
Timeline
Associate - Ops
WNS BUSINESS CONSULTING PVT LTD
09.2020 - 06.2022
Senior Associate
Optum Global Solutions
05.2017 - 02.2020
Associate
Optum Global Solutions
05.2015 - 05.2017
Bachelor of Science - Computer Science
Pandit RaviShanker University
04.2001 -
Business Analyst
CARELON GLOBAL SOLUTION
7 2022 - Current
Similar Profiles
Anupam PandeyAnupam Pandey
Product Manager at Carelon Global SolutionProduct Manager at Carelon Global Solution
Asfar UsmaniAsfar Usmani
Senior Software Engineer at Carelon Global SolutionSenior Software Engineer at Carelon Global Solution
Amit Ramesh BramhechaAmit Ramesh Bramhecha
Software Engineer II at Carelon Global SolutionSoftware Engineer II at Carelon Global Solution