Ahalya Kusuma
Saint Louis,USA
Summary
Highly skilled Data Analytics and Information Systems Professional graduate student from Saint Louis University with a Master of Science in Information Systems. Over two years of professional experience as a Senior Associate Quality Analyst-Operations at Tech Mahindra, where I excelled in developing ETL processes, predictive modeling, and data visualization using Python, R, SQL, Tableau, and Power BI. Proven track record in optimizing healthcare data analysis, enhancing claims processing efficiency, and reducing operational costs. Seeking a full-time data analyst position to leverage analytical skills and business acumen in a dynamic and innovative organization. Proficient in data analysis, predictive modeling, and data visualization using Python, R, SQL, Tableau, Scrum, SPSS and Power BI.
Overview
3
3
years of professional experience
1
1
Certification
Work History
Student Health Insurance Liaison
Saint Louis University
12.2023 - 02.2024
- Presented and communicated key aspects of student health insurance, including requirements and resources, to peers through structured presentations, increasing awareness and engagement
- Exhibited proficiency in public speaking and the ability to convey complex US health insurance and healthcare system operations information to a student audience
- Utilized PowerPoint to craft and deliver impactful presentations to student groups, ensuring clarity and retention of crucial information
- Acquired in-depth knowledge of US health insurance products and clinical and financial operations of the US healthcare system, enhancing the support provided to students
- Worked with the Student Health Insurance office to develop and implement effective communication strategies and educational materials tailored to meet student needs
Senior Associate Quality Analyst at Operations
TechMahindra
08.2021 - 05.2023
- As Senior Quality Analyst Closely monitor the team on day-to-day basis to ensure all SLAs are met and any exception is immediately escalated for resolution
- Adherence to laid down QUALITY & QUANTITY SLA's and escalates issues as required to the management
- To ensure 100% compliance to process related policies, guidelines and controls
- Monitoring work in progress making adjustments as needed; giving feedback and in part training to staff
- Addressing scheduling issues, including absences and tardiness; giving input to supervisors on performance
- Preparing weekly reports and observing the trend as per business and process perspective to meet the customer satisfaction
- Proactively shared suggestions to operations to make a habit of sharing best practices, ideas and achievement among the associates which helps to improve their performance
Claims Associate
United Healthcare Group
04.2021 - 08.2021
- Conducted thorough investigations and analyses to affirm or deny coverage fairly, assisting the legal team in defending the company against guilty parties
- Evaluated and settled complex insurance claims within strict timeframes, gathering information from diverse sources to deliver comprehensive reports
- Coordinated with the contracting department to resolve payer issues while tracking pending authorizations to avoid revenue loss
- Reviewed outstanding requests and redirected workloads to complete projects on time, demonstrating expertise as a subject matter expert on claims
- Maintained the confidentiality of patient financial records and health statuses, communicating verification and authorization status updates to facilitate decision-making
- Expedited claims processing and resolved conflicts by proposing settlements and negotiating mutually beneficial agreements with claims adjusters and examiners
Education
MASTER OF SCIENCE - INFORMATION SYSTEMS
Saint Louis University
BACHELORS OF SCIENCE -
Gitam Institute of Technology & Science
Skills
- Research Study Design
- Statistical Analysis
- Data Analysis
- Predictive Modeling
- Process Improvement
- Cost Optimization
- Conflict Resolution
- Trend Analysis
- Cross-functional Coordination
- Effective Communication
- Collaboration
- Project Management
- Healthcare Analysis
- Stakeholder Management
- Risk Management
- Portfolio Analysis
- Cost Analysis
- Research Publications
- HTML
- SQL
- Python
- R
- Tableau
- Advanced Excel
- AWS
- SPSS
- Power BI
- Machine Learning
- Data Visualization
- SAS
- C Programming
- Linux Systems
- Shell Scripting
- Advanced SQL for Data Manipulation
- Predictive Modeling Techniques
- Postman
- HTTPS
- Docker
- GitHub
- MongoDB
- PostgreSQL
- JavaScript
- Windows
- Linux
- Jira
- Wireshark
- Microsoft Office
- Photoshop
Certification
- Tableau Desktop Specialist, Tableau Software
- Microsoft Certified: Azure Data Scientist Associate, Microsoft
- Google Data Analytics Professional Certificate, Google
- Certified Business Analysis Professional (CBAP)
Projects
Predictive Modeling for Healthcare, Developed and implemented a predictive model using Python and R that reduced patient no-show rates by 30%. This improvement significantly increased clinic revenue and operational efficiency by optimizing appointment scheduling and resource allocation. Fraud Detection System, Designed and deployed a machine learning-based system to enhance financial security by minimizing false positives and negatives in transaction monitoring. This system improved the accuracy and reliability of fraud detection processes, protecting the organization from potential financial losses. Machine Learning in CI/CT Pipelines, Investigated and demonstrated the impact of integrating machine learning into Continuous Integration and Continuous Testing (CI/CT) pipelines. The project optimized software development processes by identifying regression defects early, leading to faster and more efficient software releases. Enterprise Architect for PNC Bank, Proposed an enterprise-wide cloud migration strategy that reduced operational costs by 20%. Delivered a high-level implementation roadmap for enhanced security, improving compliance with industry regulations. Enhanced cross-functional collaboration between IT and Business departments, resulting in a more cohesive enterprise-wide strategy.
Interests and achievements
- Organized and led a team of 20 in the Heart Sole Run 2.0, raising over $5,000 for heart disease research.
- Coordinated and assisted with the Orientation Ceremony as a member of the Students Council.
- Participated in the social project 'Orthopedic Library' as a member of the Rotary Club.
- Actively participated as a team player in the institute's softball team, demonstrating strong teamwork, communication, and strategic thinking skills.
Timeline
Student Health Insurance Liaison
Saint Louis University
12.2023 - 02.2024
Senior Associate Quality Analyst at Operations
TechMahindra
08.2021 - 05.2023
Claims Associate
United Healthcare Group
04.2021 - 08.2021
BACHELORS OF SCIENCE -
Gitam Institute of Technology & Science
MASTER OF SCIENCE - INFORMATION SYSTEMS
Saint Louis University
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