Djai Razat
Brockport,NY
Summary
Healthcare Data Analyst & Reimbursement Specialist with 2.5+ years of experience in revenue integrity, KPI tracking, and financial modeling. Expert in using SQL (Joins/Queries) and Tableau to mine complex datasets for pricing anomalies and utilization trends. Proven track record of preventing $8M+ in revenue leakage through proactive contract logic validation. Seeking to leverage background in medical economics to support reimbursement strategy and network operations.
Overview
2
2
years of professional experience
1
1
Certification
Work History
Price Estimation Analyst
University of Rochester
12.2024 - Current
- Revenue Integrity Auditing: Perform daily SQL-based audits on CPT, ICD-10, and HCPCS codes , ensuring alignment with governmental billing regulations and preventing $8M+ in potential denials.
- Contract Logic Validation: Reverse-engineer payer contract logic using Epic CMS and Microsoft Access to validate reimbursement rates, identifying and correcting pricing errors before claims are submitted.
- Cross-Functional Collaboration: Partner with contracting and reimbursement teams to implement payer rate updates, serving as the technical lead for post-production rate validation.
Administrative Intern
University of Rochester
08.2024 - 12.2024
- Process Improvement: Standardized patient prep documentation across 9 specialties and 20+ providers, reducing scheduling errors and staff dependency.
- KPI Analysis: Tracked and reported key performance indicators (KPIs) to identify workflow bottlenecks, directly informing management decisions on clinic efficiency and onboarding.
- Digital Transformation: Led the transition of paper-based processes to digital filing systems, enhancing provider access to records and improving compliance with prep protocols.
Outpatient Access Specialist
University of Rochester
10.2023 - 12.2024
- Denial Prevention: Mitigated revenue leakage by identifying payer coverage gaps and securing authorizations prior to service, directly reducing administrative denials.
- Financial Clearance: Managed financial clearance workflows for high-volume outpatient services, ensuring compliance with payer guidelines, and minimizing downstream payment disputes.
- Regulatory Compliance: Protected patient privacy (HIPAA) while resolving reimbursement inquiries and maintaining regulatory compliance
Education
Bachelor of Science - Healthcare Administration
SUNY Brockport
Brockport, NYSkills
- ICD-10-CM CPT HCPCS Code Interpretation
- Reimbursement Logic Claims Discrepancy Review
- Cross-System Terminology Mapping
- Microsoft Access SQL (Intermediate) Epic CMS Tools
- Workflow Validation Contract Data Alignment
- Health Informatics Foundations Patient-Facing Financial Guidance
- Data Quality Auditing Template Correction
Projects
Patient Price Estimate Request Trend Analysis (Excel, SQL, Tableau)
- Designed and built an interactive dashboard from scratch to track estimate decline rates.
- Utilized custom SQL queries to blend patient demographic data with payer contract data, identifying a trend of deviations in commercial payer contracts.
Financial Impact of Escalation: HST to In-Lab Sleep Studies (Excel, Tableau)
- Conducted a comparative reimbursement analysis between Home Sleep Tests (HST) and In-Lab studies.
- Modeled payer efficiency and cost optimization scenarios to support clinical decision-making and revenue forecasting.
CPT Blood Lab Cost & Utilization Analysis (Excel, SQL, Tableau)
- Modeled utilization for 12 high-volume CPT codes across 4 major payers.
- Identified significant pricing variances between payers, providing data-backed recommendations for future Chargemaster (CDM) pricing strategy discussions.
Certification
Google Data Analytics Professional Certificate, 08/01/25
Timeline
Price Estimation Analyst
University of Rochester
12.2024 - Current
Administrative Intern
University of Rochester
08.2024 - 12.2024
Outpatient Access Specialist
University of Rochester
10.2023 - 12.2024
Bachelor of Science - Healthcare Administration
SUNY Brockport