Satyapal Kondakindi
Merrimack,NH
Summary
Adept at software implementation and client management, I spearheaded the successful integration of Advalent's claims adjudication platform at IPMG, enhancing data migration processes and third-party collaborations. My expertise in business analysis and configuration management has consistently driven project success, showcasing a strong ability to resolve issues and train clients effectively.
I have a very good understanding of healthcare payor domain like medical claims processing/adjudication, claim repricer networks, stop loss contracts, subrogation
Overview
14
14
years of professional experience
Work History
Implementation Specialist
Advalent
10.2020 - Current
- Implemented Advalent's claims adjudication platform (payor plus) at IPMG, replacing their legacy system. (IPMG is a TPA with 160+ clients/groups)
- Led efforts to establish clear data dictionaries and coordinated with client for seamless data conversion and migration process.
- Implemented all 3rd party integration with external vendors, including PBM's, networks, repricers, and payments. Successfully facilitated over 60 file exchanges.
- Worked closely with configuration team on configuring key components including benefit definitions, plans, payments, groups, and adjudication options necessary for end-to-end claims processing.
- Defined API requirements for eligibility
- Defined and designed letter templates to implement automated letter generation
- Assisted in troubleshooting and resolving issues after project completion
Product Manager / Sr.Business Analyst
Optum/Equian
05.2015 - 10.2020
- Successfully implemented the new Subrogation platform (SubroPoint) at Equian/Optum, significantly streamlining their subrogation process
- Managed product lifecycle and introduced subrogation analytics process, knowledge-based assignment, case building rules, discovery process, investigation rules, and letters questionnaire.
- Served as a business analyst, documenting requirements for user management, user restrictions, file processing, and letter templates.
- Created precise subrogation rules utilizing ICD, CPT, Revenue codes to accurately detect accident and worker comp claims
- Developed and implemented automated work queue system using subrogation rules
Business Analyst
SCAN Health Plan
01.2014 - 04.2015
- Worked on 3rd party integration for IKA implementation at Scan Health Plan
- Actively participated in team meetings to share knowledge, exchange ideas, address challenges, and collaborate on potential solutions.
- Developed high-quality documentation to support training efforts, helping employees fully understand new systems and procedures.
- Performed gap analysis between existing systems or processes and desired state, identifying areas for improvement or enhancement.
Business Analyst
EmblemHealth
08.2012 - 11.2013
- Organized JAD sessions with SMEs of the dependent systems to gather functional and technical requirements.
- Conduct BRD walkthrough session with business, testers and developers after Responsible for requirement gathering and creating BRD for Interest Automation Project
- Served as a Business Analyst and UAT Tester for the ICD9 to ICD10 project on the Professional Claims side.
- Designed benefit packages with ICD, CPT HCPCS for configuration into the QCARE System.
- Coordinated with internal operations department to ensure accurate data.
- Evaluated benefit configurations for new and existing plans using the QCARE system.
- Modified Preauthorization module to incorporate expansion of the ICD Field while preserving the existing workflow.
Business Analyst
Emids
05.2010 - 07.2012
- Conducted requirement gathering and analysis to enhance client's Registry based PQRS reporting solution.
- Developed emids PQRS reporting solution, encompassing use cases for all 2012 PQRS reporting measures (Medicare Part-B FFS patients).
- Worked as a Business Analyst for Davita's Falcon 2.0 project, serving various modules such as Orders, Patient Chart, and Reporting.
- Developed Physician Noting Application (Physician Portal - iPad application) for Davita physicians' use. Extensively collaborated on creating use cases for eRx application as well.
- Conducted thorough requirement gathering and analysis for Patient Portal, Scheduling, and Orders in EHR systems
- Collaborated on the enhancement of crucial features within an EHR application, encompassing Scheduling and Registration, Clinical Documentation, and Patient Portal
Education
Master of Science - Information Technology
University of Central Missouri
Warrensburg, MO12.2006
Skills
- Healthcare payor domian
- Issue Resolution
- Business Analysis
- Software Implementation
- Benefit Configuration Management
- Implementation Management
Timeline
Implementation Specialist
Advalent
10.2020 - Current
Product Manager / Sr.Business Analyst
Optum/Equian
05.2015 - 10.2020
Business Analyst
SCAN Health Plan
01.2014 - 04.2015
Business Analyst
EmblemHealth
08.2012 - 11.2013
Business Analyst
Emids
05.2010 - 07.2012
Master of Science - Information Technology
University of Central Missouri