SREEDHAR THOTAKURI
Concord,NC
Summary
Experienced Data Analyst with 19+ years in healthcare systems, data analytics, and performance improvement. Skilled in leading cross-functional teams, analyzing complex healthcare datasets, and offering actionable insights. Proficient in SQL, Python, Tableau, and knowledgeable in healthcare data standards like HIPAA, HL7 and EDI. Seeking consultant role to leverage analytical expertise and healthcare domain knowledge for promoting data-informed decision-making and operational excellence.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Lead IT Analyst
Sentara Healthcare
05.2023 - Current
- Led cross-functional teams across Claims, Enrollment, Clinical, Utilization Management, Provider, and Pharmacy departments, supporting Medicare, Medicaid, and Commercial lines of business.
- Managed projects using Agile/SCRUM and Waterfall methodologies, overseeing the full project life cycle from initiation to closure.
- Collaborated with senior leadership to resolve conflicts, manage change requests, and align project goals with organizational policies and procedures.
- Directed task assignments and prioritization for a team of 30+ resources, ensuring efficient execution and timely delivery.
- Conducted regular team meetings, project reviews, and defect triage sessions to monitor progress and address issues proactively.
- Delivered comprehensive status reports and defect matrices to stakeholders and test managers.
- Analyzed healthcare data from QNXT to identify trends and recommend operational improvements.
- Developed and optimized SQL queries and Python scripts for data extraction, transformation, and visualization.
- Built interactive dashboards using Power BI and Easy BI, enabling smart filtering and real-time reporting for internal and external stakeholders.
- Utilized Jira and ServiceNow for issue tracking, request management, and workflow optimization.
- Ensured data integrity and compliance with HIPAA and CMS standards; proficient in HIPAA EDI transactions.
- Acted as the primary client interface, managing escalations, addressing complaints, and ensuring high levels of customer satisfaction.
- Healthcare Domain – Medicare, Medicaid, and Commercial Products
IT Analyst
Uptik Solutions (Client: Blue Cross Blue Shield of Michigan)
12.2019 - 05.2023
- Supported the development and enhancement of a healthcare system enabling patients and providers to manage medical processes and records efficiently.
- Analyzed and validated claims data to determine processing status (e.g., suspended, adjudicated, or submitted), ensuring accuracy and compliance with payer rules.
- Applied working knowledge of HIPAA EDI transactions including 835, 837, 820, 277CA, and 276/277 to support data exchange and operational workflows.
- Collaborated with Business and Systems Analysts to interpret requirements, assess feasibility, and ensure alignment with business objectives.
- Evaluated the clarity and completeness of business requirements, providing feedback to improve testability and implementation readiness.
- Participated in all phases of the project lifecycle, contributing to planning, requirement analysis, and stakeholder communication.
- Used Azure DevOps to manage and track user stories, tasks, and issues; maintained traceability between requirements, test cases, and outcomes.
- Verified that products and services met specified business and regulatory requirements through structured validation processes.
- Monitored project progress, tracked deliverables, and supported team coordination to ensure timely execution of tasks.
- Ensured all deliverables complied with HIPAA standards and internal quality metrics.
- Healthcare Domain – Claims, EDI Transactions, and Provider/Patient Systems
Healthcare IT Manager
TS Staffing Solutions
- Directed IT operations within the rehabilitation department, integrating technology solutions to support clinical workflows and improve patient care delivery.
- Managed and safeguarded confidential legal documents, payroll data, and patient health records, ensuring strict adherence to HIPAA and data security standards.
- Supervised medical coding and billing activities, ensuring accurate use of ICD-9, CPT, and HCPCS codes for rehabilitation services to optimize reimbursement and reduce claim denials.
- Collaborated with billing teams to resolve coding discrepancies, conducted audits, and ensured compliance with payer and regulatory requirements.
- Supported the implementation and optimization of Electronic Health Record (EHR) systems, aligning IT capabilities with clinical and administrative needs.
- Provided training to staff on ICD-9 coding, billing procedures, and documentation standards to enhance accuracy and efficiency.
- Delivered educational programs to patients recovering from cardiac events (e.g., heart attacks, PTCA, bypass surgery), promoting informed recovery and lifestyle changes.
- Developed and managed vocational rehabilitation initiatives for developmentally disabled adults, integrating technology to support skill development and community engagement.
- Acted as a liaison between clinical, administrative, and IT teams to ensure seamless communication and system integration.
- Provided technical support and training on healthcare applications and documentation tools, improving staff productivity and reducing operational errors.
- Maintained a professional and empathetic communication style with patients, families, and staff, fostering a supportive and respectful care environment.
QA Healthcare Analyst
Charter Home HealthCare, USA
05.2010 - 04.2012
- Conducted quality assurance reviews of clinical documentation including OASIS Start of Care (SOC), Resumption of Care (ROC), Recertification, and Discharge assessments to ensure accuracy, completeness, and compliance with CMS and Medicare guidelines.
- Reviewed and validated Physical Therapy Evaluations, ensuring alignment with physician orders, patient goals, and regulatory standards.
- Audited SOAP notes for consistency, clinical relevance, and adherence to agency protocols, ensuring that subjective, objective, assessment, and plan components were properly documented.
- Ensured correct usage of CPT codes, ICD-9 diagnosis codes, and appropriate modifiers for billing and reimbursement purposes.
- Collaborated with clinical staff to correct documentation errors and improve charting practices, reducing billing delays and claim denials.
- Provided in-depth Rx data analysis, evaluating medication usage patterns and aligning them with benefit designs and clinical program recommendations.
- Worked closely with insurance carriers, medical directors, and internal leadership to resolve billing discrepancies and support accurate claims processing.
- Coordinated with DME (Durable Medical Equipment) suppliers, submitting and tracking prior authorization requests to ensure timely delivery of patient equipment.
- Participated in internal audits and compliance reviews, identifying gaps in documentation and recommending corrective actions.
- Trained clinicians on proper documentation practices, coding standards, and OASIS accuracy to enhance overall quality and compliance.
- Maintained detailed logs of QA findings and collaborated with the billing department to ensure all claims met payer requirements.
- Supported the development of internal QA policies and workflows to streamline review processes and improve operational efficiency.
Education
MSMIT - IT
Sullivan University
Lexington12-2015
MBA - Health Care Management
Sullivan University
Lexington12-2013
European Masters in Adapted Physical Activity - Science
Katholieke Universiteit
Leuven, Belgium01-2006
Bachelors in Physiotherapy - Science
SIMS College of Physiotherapy
Guntur, India03-2003
Skills
Data Analytics & Visualization
- Languages & Libraries: Python (Pandas, NumPy, Matplotlib, Seaborn, Scikit-learn, TensorFlow)
- Visualization Tools: Tableau, Power BI
- IDEs & Platforms: Jupyter , Spyder, Google Colab, VS Code, PyCharm, Python IDLE
Version Control & Collaboration
- Tools: Git, GitHub
Database & ETL
- Languages: SQL
- Data Modeling: Relational and dimensional modeling for healthcare datasets
Healthcare Data Expertise
- Systems: QNXT, Navigator
- Domains: Claims, Utilization Management, Clinical
- EDI Transactions: 834 (Enrollment), 835 (Remittance Advice), 837 (Claims) – review and change management
Project Management & Methodologies
- Frameworks: Agile, Scrum, Waterfall
- Tools: Jira, Azure DevOps, ServiceNow
- Roles: Sprint planning, backlog grooming, stakeholder communication, cross-functional coordination
Certification
SAFe Scrum Master Certification
Salesforce Administrator
Salesforce Platform Developer
Data Science with Python ( In progress)
Licensed Physical Therapist (MI, NY, NC)
Languages
English
Hindi
Telugu
Timeline
Lead IT Analyst
Sentara Healthcare
05.2023 - Current
IT Analyst
Uptik Solutions (Client: Blue Cross Blue Shield of Michigan)
12.2019 - 05.2023
QA Healthcare Analyst
Charter Home HealthCare, USA
05.2010 - 04.2012
Healthcare IT Manager
TS Staffing Solutions
MSMIT - IT
Sullivan University
MBA - Health Care Management
Sullivan University
European Masters in Adapted Physical Activity - Science
Katholieke Universiteit
Bachelors in Physiotherapy - Science
SIMS College of Physiotherapy
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