Jarmin Patel

Client: BCBS (Blue Cross Blue Shield)for multiple States

• Communicated with customers, competitors, and suppliers to stay abreast of industry or business trends.
• Provided technical support for existing reports, dashboards, or other tools.
• Created the claim from scratch to the final step.
• Generated the EDI 837I and 837P to load a claim into the system.
• Developed and executed complex SQL queries to extract, analyze, and validate claims, enrollment, and provider data from payer systems.
• Managed and led meetings and workshops with multiple departments to solidify requirements.
• Worked on the benefit plan and payment configuration with the provider and the professional.
• Partnered with business stakeholders to gather system configuration requirements during the implementation of new plan designs.
• Participated in full lifecycle system configuration projects, including documentation, testing, and go-live support.
• Collaborated with QA teams to validate system changes and supported UAT and defect triage.
• Used SQL extensively to validate benefit logic, troubleshoot configuration issues, and ensure clean data transitions.
• Coordinated with product and compliance teams to gather specifications and translate them into accurate system configurations.
• Reviewed benefit coding for accuracy, including copays, coinsurance, accumulators, and authorization rules.