Aishwarya Voraganti

Experience

1. Program Specialist Ii

   EVERSANA

   Jul 2025 — Present · Mason, OH, US

   Managing patient and provider support, handling 30+ high-volume inquiries via phone while maintaining a 98% satisfaction rating. Performing benefit verification, prior authorization, and pharmacy claims processing using Salesforce ACTICS, PBM ensuring HIPAA compliance and accurate documentation, including AE and PQC reporting. Supporting patient portal enrollments, PTR claim processing for oncology medications and MRI-based clinical research programs, maintaining strict adherence to blinding protocols and data confidentiality standards by ensuring timely resolution. Managing medical claims and reimbursement workflows using MedX, collaborating with clients, payers, pharmacies, and internal teams to resolve discrepancies, delays, and enrollment issues across multiple medication portfolios. Supported pharmacy program workflows, including 340B-related claims and pharmacy processes, ensuring compliance with internal audit standards and regulatory requirements. Conducted data validation and performed financial reconciliation of claims, reimbursement amounts, payer remittances, pharmacy invoices, inventory activity, and wholesaler pricing using advanced Excel and SQL to identify discrepancies and optimize financial accuracy. Utilized Advanced Excel, Python, SQL, Tableau, and Power BI to analyze claims, cost, and utilization data, supporting quality improvement initiatives and reducing processing errors by 15%. Analyzed high-volume reimbursement datasets records) using advanced Excel (Pivot Tables, XLOOKUP, complex formulas) to track medication trends, claim denials, payment patterns, and identify revenue leakage and cost optimization opportunities. Interpreted payer guidelines and federal reimbursement policies to support accurate claims adjudication, prepare variance reports, and deliver financial summaries highlighting reimbursement gaps and cost discrepancies for leadership review.

Education

• Jawaharlal Nehru Technological University

  Doctor of Pharmacy

• Indiana University Indianapolis

  Master's degree, Health Informatics

  2023 — 2025