Navjot Chakravarti
South Lyon,MI
Summary
Senior Business Analyst with 14+ years of experience in Medicare Advantage operations, claims processing, enrollment workflows, and healthcare system implementations. Specialized in translating CMS regulatory requirements and business needs into functional system solutions across platforms including Facets, NASCO, HealthRules, ClaimsXten, Salesforce, and ServiceNow.
Proven experience leading cross-functional teams, gathering and documenting requirements (BRD, SRS, user stories), supporting UAT cycles, and driving process improvements that reduce operational inefficiencies and strengthen compliance outcomes.
Strong background in claims lifecycle management, enrollment processing, rejection workflows, and regulatory reporting within high-volume healthcare environments.
Overview
14
14
years of professional experience
Work History
Business Analyst
Cehas Plan Administrators
Remote
02.2025 - 11.2025
- Supported Medicare Advantage operations by analyzing enrollment and claims workflows to identify inefficiencies and improve processing accuracy.
- Gathered and documented business and CMS-driven requirements for system enhancements and operational updates.
- Developed SOPs and structured documentation to standardize workflows and ensure compliance alignment.
- Collaborated with business and technical teams to translate requirements into functional specifications.
- Created reporting outputs using Advanced Excel to track operational trends and performance metrics.
- Assisted in system enhancement initiatives impacting enrollment and claims processing accuracy.
Claims Lead /Senior Business Analyst
UST Global
Remote
08.2022 - 02.2025
- Led a team of 17 analysts supporting claims processing operations and system enhancement initiatives.
- Improved operational efficiency by 30% by identifying workflow gaps and implementing process improvements.
- Gathered requirements for claims system enhancements supporting Medicare Advantage workflows.
- Designed KPI dashboards to track claims performance, turnaround time, and operational accuracy.
- Conducted root cause analysis on claims issues and provided actionable recommendations to leadership.
- Supported UAT cycles ensuring system readiness and defect resolution prior to deployment.
Business Analyst
UST Global
Remote
08.2021 - 08.2022
- Documented business requirements and system specifications for claims processing improvements.
- Supported UAT execution including test case creation, validation, and defect tracking.
- Built workflow diagrams using Visio and Lucidchart to identify process gaps.
- Developed Excel-based reporting dashboards for operational monitoring.
Sr. Business Analyst
Ford Motor Company
Detroit, MI
01.2020 - 07.2021
- Supported Agile delivery teams by managing requirements, user stories, and backlog items.
- Facilitated stakeholder discussions to align business needs with system development.
- Documented functional requirements supporting enterprise system enhancements.
Sr. Business Analyst
Healthfirst
New York, NY
04.2017 - 12.2019
- Developed BRDs and system requirements for Medicare Advantage initiatives.
- Led stakeholder workshops to gather and validate business requirements.
- Translated CMS regulatory updates into functional system requirements.
- Supported system testing and validation activities.
Sr. Business Systems Analyst
EmblemHealth
New York, NY
01.2014 - 03.2017
- Developed system requirements supporting claims processing workflows.
- Conducted gap analysis and supported process improvement initiatives.
- Partnered with IT teams to implement system enhancements.
Sr. Business Analyst / Systems Analyst
Blue Cross Blue Shield of Michigan
Detroit, MI
08.2011 - 11.2013
- Led UAT testing for major system implementations including ICD-10 readiness.
- Supported NASCO system enhancements and defect tracking.
- Assisted in CMS and HIPAA compliance initiatives.
Education
Bachelor of Science - Sociology
Wayne State University
Detroit, MI04.2009
Skills
Medicare & Healthcare Systems
- Medicare Advantage Operations
- CMS Compliance & Regulatory Implementation
- Claims Processing & Enrollment Workflows
- Rejection Letters & Resolution Processes
Systems & Tools
- Facets, NASCO, HealthRules, ClaimsXten
- Salesforce, ServiceNow
- Advanced Excel (Pivot Tables, Power Query, Reporting)
- Jira, Confluence, SharePoint
- Visio, Lucidchart
Business Analysis
- Requirements Gathering (BRD, SRS, User Stories)
- UAT Planning, Execution & Defect Management
- Process Mapping & Workflow Optimization
- Root Cause Analysis
- KPI Reporting & Dashboard Development
Languages
Punjabi
Native or Bilingual
Hindi
Full Professional
Bengali
Limited Working
Timeline
Business Analyst
Cehas Plan Administrators
02.2025 - 11.2025
Claims Lead /Senior Business Analyst
UST Global
08.2022 - 02.2025
Business Analyst
UST Global
08.2021 - 08.2022
Sr. Business Analyst
Ford Motor Company
01.2020 - 07.2021
Sr. Business Analyst
Healthfirst
04.2017 - 12.2019
Sr. Business Systems Analyst
EmblemHealth
01.2014 - 03.2017
Sr. Business Analyst / Systems Analyst
Blue Cross Blue Shield of Michigan
08.2011 - 11.2013
Bachelor of Science - Sociology
Wayne State University