Prachi Verma

Sr Business Configuration Qa Analyst Iii @Innova Solutions

CA

Experience with ICD-9, ICD-10, CPT, UB-04, CMS-1500 coding and data• Experience with SQL and Excel used for data analysis and validation. Gathered, retrieved, and analyzed clinical, claims, and demographic data from healthcare systems supporting Medicare and Medicaid programs, ensuring accuracy and compliance with regulatory standards.• Performed coding validation and data abstraction activities by interpreting ICD-9, ICD-10, CPT, and claim-level data (UB-04 and CMS-1500) toensure data integrity and reporting accuracy.• Supported data quality assurance initiatives through detailed analysis, validation checks, and defect resolution to improve the completeness,consistency, and reliability of patient and claims records.• Conducted regular data reviews and reconciliations using SQL and Excel, identifying discrepancies, and supporting corrective actions alignedwith healthcare data governance practices.• Designed and executed UAT plans, test cases, and validation scripts to verify accuracy of coded clinical and administrative data prior to systemreleases.• Collaborated with clinical, operational, and technical stakeholders to interpret healthcare documentation, validate requirements, and ensureaccurate representation of clinical and demographic information in enterprise systems.• Maintained detailed documentation and audit trails for testing, data validation, and system changes in accordance with healthcare complianceand privacy requirements.• Supported statistical and operational reporting by analyzing large healthcare datasets and producing structured reports for leadership andregulatory stakeholders.• Assisted in release-of-information readiness by ensuring data completeness, proper coding logic, and adherence to data quality and privacystandards.• Participated in process improvement initiatives to enhance healthcare data workflows, reduce errors, and support continuous data qualityimprovement.Technical Skills: SQL, Excel (V/X Lookups,•

Chhattisgarh Swami Vivekanand Technical University, Bhilai

Bachelor of Engineering (B.Eng.), Computer Engineering

Savitribai Phule Pune University

Master's degree, Human Resources Management/Personnel Administration, General

University of Illinois Springfield

Master of Science (M.S.), Management Information Systems, General