Sagar Patil

About Sagar Patil

As a PMO Coordinator with hands-on experience in US Healthcare operations and data…

Experience

1. Associate Analyst

   Tech Mahindra

   Feb 2024 — Present · Pune, IN

   Managing enrollment processes for patients in various US-based healthcare insurance programs. This involves ensuring accuracy in data visualization, analysis and validation for eligible individuals under different healthcare policies by using power BI/Tableau- Designed and implemented end-to-end data pipelines through Electronic Data Interchanges (EDI), improving data accessibility for cross-functional teams- Administering healthcare policies, adjudicating claims, and performing e-file analysis using Oracle SQL to streamline data processing and ensure timely, accurate claim handling. This analysis helps ensure compliance and correct claim processing based on policy terms- Identifying and reporting discrepancies in policy data between different vendors and stakeholders. Utilizing Excel automation, this role analyzes and resolves inconsistencies, ensuring data integrity across all entities involved- Managing COBRA, Medicare, and Medicaid benefits, including enrollments and terminations, based on requested tenure. This ensures continuity of coverage for eligible individuals as required by federal law- Collaborating with specialists in the USA to address complex issues through a JIRA ticketing system, which involves tracking and managing reported issues to maintain smooth operation of insurance services- Analyzing data related to workplace group benefits and protection, focusing on eligibility, benefit calculations, and compliance with policy terms- Managing periodic updates such as age reductions, increments, decrements, and other benefit adjustments based on policy requirements, to ensure that patient records remain accurate and up-to-date.