SURRENDRAN SEKAR

* Leveraged Azure Databricks for data processing, transformation, and analysis tasks. Developed and optimized Spark jobs using SQL within Azure Databricks environment.
* Handle huge data and responsible for data quality, data organization, metadata and data profiling. Import the data and performed the quality control steps to determine raw data quality.
* Create new Big data and Azure Databricks datasets from raw data files using Import Techniques and modify existing datasets using Set, Merge, Sort, Update, and other conditional statements.
* Develop and change implementation logic for the new and existing clients based on the Change Requests received from the client.
* Extensively perform Data Cleansing during the ETL Extraction and Loading Phase by analyzing the raw data and writing SQL, Pyspark Program and creating complex reusable Macros
* Direct and participate with team members in the analysis, development and delivery of all support and project work for assigned group(s)
* Develop logics to map the client data with the Data Warehouse. Provided technical guidance and support to team members on Azure Databricks usage and best practices.
* Constantly looking for ways to improve processes and implement new initiatives and make sure all staff understands them
* Giving prompt and accurate information on individual staff member performance. Perform resource planning, tracking, and reporting for all assigned team members.

• Led initiatives to develop and enhance ETL processes in Azure Databricks for healthcare data management, processing complex datasets with PySpark and Python.
• Implemented automated data profiling and quality control scripts, detecting anomalies and reducing manual defect investigations by 40%.
• Collaborated with stakeholders to refine implementation logic based on change requests, resulting in a 25% decrease in rework cycles.
• Coordinated resource planning, workload allocation, and performance tracking, improving team efficiency and on-time delivery metrics.

* Evaluates and processes claims in accordance with company policies and procedures, CMS guidelines.

* Reviews and analyzes data for in-process claims in order to identify and resolve errors prior to final adjudication.

* Exercises good judgment and remains knowledgeable in related company policies and procedures.

* Achieves teamwork, production and quality standards in order to assure timely, efficient and accurate claims processing.· Conveys a strong professional image, exhibits interest and positive attitude toward all assigned work.

* Extensive knowledge of Commercial, Medi-Cal/Medicaid and Medicare claims processing guidelines.

* Knowledge of medical billing including ICD-10, CPT, CMS-1500, UB-04 etc.

* Knowledge of different providers’ payment methodologies (i.e., capitation, fee for service based, other negotiated flat rates, RVS pricing, Per Diem, DRG pricing, etc.)

* Responsible for filing additional claims that are in a pending status until all required information is received.

* Responsible for pulling files and paid them when required information is received.

* Organized and reviewed medical claims for completeness, accuracy and took appropriate action to ensure procedures are followed.

* Assisted Medical Claims Examiners in reviewing approved claims for payment, ensuring information is accurate.