Specialist, Medical Audit Analytics
Oman Insurance
مجموع سنوات الخبرة :5 years, 0 أشهر
Project Description:-
Project scope involves development of executive reports using SAS VA. Identifying creative ways of establishing connection between various field with a view to identifying fraud, waste and abuse (FWA) in medical claims
Responsibilities:-
Worked as a SAS VA developer responsible for,
• Deal with large amounts of data (facts, figure and number crunching)
• Work experience with line item healthcare claims and PBM information is preferred.
• An understanding of CPT, ICD-9, DRG codes is preferred.
• Experience and proficiency leveraging SAS, including loading data, writing update and select statements, and joining tables.
• Experience with Excel spread sheets and other office productivity applications to share and present analytic results.
• Experience with statistical analysis tools such as SAS.
• Experience with business Intelligence tools such as MS-Power-BI, SAS-VA
• Presents data in charts, graphs, and table (pie chart, bar-chart, line chart, cross tab and list control) as requires using SAS Visual analytics.
• The purpose to identifying high risk providers and ultimately leading to preparing claims samples to audit for on fields auditors.
• Collecting, transforming, validating, summarizing, and publishing a meaningful claims analysis report.
• Developed executive reports like benefit codes by claims, top 50 providers by amount, etc.
• Created interactivity between objects, created section prompts and report prompts.
• Used different containers like stack container.
• Tested functionality and data integrity, calculated column, aggregation of the report.
Projects ProfileClient: - Daman, UAE
Project Name: - Population Health Dashboard.
Project Description:-
Population Health Dashboard abbreviated as PHD is the analysis of population of Abu Dhabi emirate with the Disease Burden. Count of the number of people suffering from various diseases which included data over the years. Forecasting the same for the next year so that the C level could analyze the same and define the Policy for the same.
Responsibilities:-
Worked as a Power-BI Consultant/Visual Analyst responsible for,
•Responsible for developing reports using Microsoft Power-BI (SSIS, SSRS and SSAS)
•Involved in initial requirement gathering session, given my inputs in development about layout and functionality.
•Developed executive reports like Revenue by geography, top 10 diseases, Gross profit, gross margin, total sale, Sales growth, summary report etc.
•Creation of Power BI dashboard and transforming the manual report, support Power BI dashboard deployment.
•Experience in Power BI visual, data extraction and power query for data transformations.
•Used slicer visual for filtering as per page filter and requirement.
•Used stacked bar chart, pie-chart to shows diseases comparison.
•For aggregations used to crate Measure column.
•Understand the underlying data and able to map the same with the dashboard.
•Analyze functional/non-functional for a better understanding requirement
Client: - Optima Health Project Description:-
This project is to cater the need of designing and creating a data warehouse populated with the various payments and claims related to customers. Various source systems generate data files which contain the information about claims, adjustments, payments, providers, members etc. Data in the files first needs to be validated and then data is extracted and populated in the target data ware house datasets through base SAS.
Responsibilities:-
Worked As A ETL & BI Developer
• Responsible for developing ETL jobs Using SAS Programming.
• Understanding the technical design and perform various business validations on the data.
• Data analysis, management and finally populating the target datasets.
• Generating & comparing target datasets with source datasets.
• Responsible for developing ETL jobs for Healthcare solution
• Used Parallel Processing, auto-call libraries, pass-through queries in order to improve performance.
• Modularized code using macros, used macro quoting functions.
• Followed standard naming conventions, created summary and detail logs.
• Created documentation of work, Knowledge transfer session with peer and client.
• Understanding requirements, understating integrated system data model.
• Finding relationship between tables, understating business aspect of data.
• Understanding Report specification, report layout and functionality.
• Developed information map using SAS Information Map studio.
• Used pre-filters in order to show data related to patient if he logged in, show treatment information for doctor related to him only, used row level security in report.
• Create cascaded prompts, crated calculated and aggregated measures, created calculated members in info map studio.
• Created stored process and used stored process in web report studio.
• Created web reports, used section filters, report filters and object filters.
• Used report with group breaks, used different graphical objects like, table, cross tab, pie chart, bar chart, tile chart etc.