NISHANLANG KHONGLAH

The focus of the project is the handling of HIPAA X12 and ANSI EDI transactions, namely, the EDI 837 health care claim transaction, EDI 275 claim and authorization attachment transaction, and EDI 824 Application Advice transaction for pre-adjudication of health care claims. This entails supporting the migration of claims data and microservices from legacy system TIBCO to modern system EDIFECS and supporting the development of claims pre-adjudication APIs such as Member Plan Mapping API, Provider Selection API, Member Selection API, and Oasis Document API which are all critical to the timely processing of healthcare claims, claim attachments, authorization attachments. My responsibilities involve collaboration among peer business system analysts, application software developers, and other key stakeholders to coordinate and drive functional testing efforts of code implementations. This effort involves performing data analysis to identify errors and any code-implementation defects. I am also tasked with leading a new health plan implementation and am responsible for gathering requirements from various stakeholders to drive EDI implementation efforts for the 837, 275, and 824 transactions.

• Led the handling of HIPAA X12 and ANSI EDI transactions, including EDI 837, EDI 275, and EDI 824 for pre-adjudication of healthcare claims.
• Supported migration of claims data and microservices from legacy system TIBCO to modern system EDIFECS.
• Developed and support claims pre-adjudication APIs critical to timely processing of healthcare claims.
• Collaborated with business system analysts, application software developers, and stakeholders to coordinate and drive functional testing efforts.
• Performed data analysis to identify errors and code-implementation defects.
• Led new health plan implementations, gathering requirements from stakeholders to drive EDI implementation efforts.
• Utilized SQL for querying claims data and performing data analysis.
• Provided production support to triage and resolve high-priority bugs.
• Presented analysis findings and demos of deployed code changes to stakeholders.
• Supported Product Owner and Scrum Master in building and maintaining product backlogs in JIRA.
• Identified needed business improvements and determined appropriate systems required to implement solutions.
• Collected, defined and analyzed business requirements.
• Trained business personnel in use of systems.
• Gathered, reviewed and reported on findings.
• Coordinated data migration and consolidation efforts.
• Analyzed existing systems and databases and recommended enhancements to solve business needs
• Troubleshot incidents reported by end-users to schedule system changes and identify permanent solutions.
• Oversaw document development across project workstreams to create internal control statements per compliance and regulatory standards.

The project involved aligning paid time off (PTO) and time tracking of PayPal employees in Brazil and Japan (on Workday and Kronos) according to recent changes in Brazilian and Japanese regulations. The project also involved analysis of user accesses on Workday to align existing accesses according to the principles of Least Privilege Access. Workday is used for all PayPal HCM operations, and I was tasked with documenting requirements and driving key stakeholder engagement to develop detailed requirements that would be used for system design and build.

• Aligned paid time off (PTO) and time tracking of PayPal employees in Brazil and Japan according to regulatory changes.
• Interacted with internal customers to understand business needs and translate into requirements and project scope.
• Conducted impact analysis and optimized HR processes on Workday.
• Led efforts to define time calculations for overtime pays, reducing solution design and development time.
• Developed process flow diagrams for user access management on Workday and Salesforce using Microsoft Visio.
• Utilized data visualization techniques to present and explain complex data sets.
• Analyzed data to identify root causes of problems and recommend corrective actions.
• Developed and implemented data governance policies and procedures.

This position primarily entailed supporting tutoring services for the Department of Economics.

• Led undergraduate tutoring sessions for core courses in Microeconomics, Macroeconomics, and Econometrics

The project involved providing research assistance/analysis, supporting statistical analysis of mortgage data using R, and coauthored a paper on measuring race- and gender-based gaps in mortgage denial rates by presenting an analysis of the variations in these denial rates across major mortgage granting institutions in the United States and the state of California using data from the Home Mortgage Disclosure Act 1975.

• Conducted statistical analysis of mortgage data using R and coauthored a paper on race- and gender-based gaps in mortgage denial rates.
• Supported literature reviews and statistical estimations using Blinder-Oaxaca-Fairlie (BOF) decomposition.

This position involved providing publication support to researchers and academics.

• Reviewed and edited Computer Science and Mathematics research papers and manuscripts.
• Performed scholarly database searching and mining.
• Ensured publication-ready delivery and provided feedback to freelance editors.

My core responsibilities involved analyzing undergraduate-level curriculum across a spectrum of subjects ranging from Philosophy, Logic, Critical Thinking, Psychology, Sociology, World History, U.S. History, to Sports Psychology, Sports Nutrition, Music History, Compensation, Criminal Justice, and Alcohol and Substance Abuse. Based on the analysis, I was tasked with developing assessments for undergraduate-level curriculum. I was also actively involved in driving project delivery while ensuring compliance to quality standards and client feedback.

• Analyzed undergraduate-level curriculum and developed assessments for various subjects.
• Authored and edited assessments on the digital adaptive learning platform LearnSmart.
• Supported project delivery and maintenance of live adaptive learning modules.
• Trained and mentored new resources and developed training content and manuals.

This position primarily involved providing back-end IT support to American Express employees.

• Provided back-end IT support to American Express employees.
• Handled Resource Access Control Facility on mainframe sessions and provided networking support.
• Supported virtualization operations on Citrix servers and secured financial data in compliance with service level agreements.