Swathi Indlamudi
Houston,USA
Summary
Associate with over 6+years in the healthcare sector, specializing in testing and configuration with expertise in MSSQL, PL/SQL.Demonstrates strong analytical skills and a keen ability to manage complex claims processing, ensuring precision and compliance. Eager to leverage technical proficiency and analytical insights to enhance team performance and drive process improvements in a dynamic environment.
Overview
7
7
years of professional experience
Work History
Team Member
Cigna Healthcare
11.2024 - Current
- Mapping business requirement to the technical design.
- Conducted testing of claims from various sources.
- Worked on subscriber, pre-authorization rules, eligibility checks, warning and pend resolutions, AGIP, PCA (Process Controlling Agent), Workflow, BPA.
- Validated the correct application of benefits and rules for claims.
- Participated in executing test cases and generating test logs for different scenarios.
Facets Configuration/Testing
Select Health
03.2021 - 12.2023
- Analyzing the functional & business requirements and involved in preparing Config Design document and Test Plan, test scenario creation, test case creation, test data setup, test execution and defect management activities.
- Tested claims through various sources.
- Worked on pre-authorization rules, eligibility check, warning and pend resolutions, AGIP, PCA (Process Controlling Agent), Workflow, BPA and special claims (behavioral claims).
- Validated whether the benefits/rules applied correctly for both professional and institutional claims.
- Involved in execution of Test cases, and creating test logs with different scenarios.
- Prepare Daily Status Report, Defect tracker, Clarification tracker, test results with screenshots on daily basis for the allocated Project and send to Onsite counterparts.
- Maintaining issue & clarification log. Analyzed functional requirements, created test plans, and executed comprehensive testing for claims processing, ensuring accuracy in benefit applications.
- Validated pre-authorization rules, eligibility checks, and special claims, maintaining meticulous documentation for daily status reports and defect tracking.
- Coordinated with onsite counterparts, sharing test results and clarifications, fostering effective communication in a cross-functional team environment.
Program Analyst Trainee
Blue Shield California
03.2019 - 02.2021
- Analyze and research product matrices for the scope of configuration and unit testing.
- Raising the risk associated for timely deployment, complexity and priority related issues ahead of time.
- Exposure to JIRA tool.
- Improve test cases to meet latest business requirements.
- Preparation of test scenarios for configuration testing includes Functional and Regression testing.
- Preparation of Subscriber load files and XC builds for claims testing.
- Validating configurations through Facets front end using different applications and Facets back end by running efficient SQL queries in Oracle.
- Set Claim Processing data for different Facets Module like for Pricing and Product configuration.
Education
Bachelor of Technology -
JNTUK
Skills
- SQL
- PL/SQL
- Facets
- JIRA
- jama
- Healthcare
- Testing
- Configuration
- Analysis
- MSSQL
- JAMA
Languages
English
Professional Working
Additional information
Work Experience
Project#1: Blue Shield California
Position: Program Analyst Trainee
Company: Cognizant Technology Solution
Duration: Mar 2019 - Feb 2021
Role: Associate (HPC-Technical)
Client: Blue Shield California
Responsibilities:
- Test Planning and Test Case Design
- Analyze and research product matrices for configuration and unit testing
- Raising risk associated with deployment, complexity, and priority issues
- Exposure to JIRA tool
- Improve test cases to meet business requirements
- Preparation of test scenarios for configuration testing
- Preparation of Subscriber load files and XC builds for claims testing
- Facets Testing and configuration validation
- Working on claims adjudication and processing
- Validating BSDL, service payment, and service rules configurations
- Understanding product benefit configuration
- Verifying Qualifier groups and Global agreements
- Creating defect sheets for Jira tickets
- Maintaining Known Errors Database (KEDB)
- Produce test results/screenshots for QA & UAT testing
- Training new team members
- Meeting SLA as per client's requirement
Project#2: SELECT HEALTH
Duration: March 2021 – Dec 2023
Role: Team Member
Technology: MSSQL Developer, Facets, JAMA
Analyzing PBR requirements through Jama
- Preparing Config Design documents and Test Plans
- Testing claims from various sources
- Working on pre-authorization rules, eligibility checks, and special claims
- Validating benefits/rules for professional and institutional claims
- Executing test cases and updating through Jama
- Preparing daily status reports and defect trackers
- Maintaining issue & clarification logs.
- Project#3
Company: Cigna Healthcare
Duration: Nov 2024 - present
- Mapping business requirement to the technical design
- Conducted testing of claims from various sources.
- Worked on subscriber, pre-authorization rules, eligibility checks, warning and pend resolutions, AGIP, PCA (Process Controlling Agent), Workflow, BPA.
- Validated the correct application of benefits and rules for claims.
- Participated in executing test cases and generating test logs for different scenarios.
Timeline
Team Member
Cigna Healthcare
11.2024 - Current
Facets Configuration/Testing
Select Health
03.2021 - 12.2023
Program Analyst Trainee
Blue Shield California
03.2019 - 02.2021
Bachelor of Technology -
JNTUK