Rohit Parkar

Experience

1. Fico Blaze Rules Developer Architect

   Atomic North

   Apr 2023 — Present

   Project: Express Scripts (Canada)- Adjudication (Team Size 8) The ESC Web Pharmacy adjudication system is a claims processing system operated by ESC on behalf of insurance carriers and other third party administrators (TPAs). The system processes both manual and EDI claims. The principal functions of the system are to receive and verify claims, validate a client’s eligibility, establish coverage in accordance with the plan’s parameters, determine the payable amount of the claim. Responsibilities- Define and implement the FICO Blaze rule architecture for the adjudication system. • Convert the business requirements of the identified adjudication programs into rules requirements.Design object model based on the elements/information required on the rule service side for the decision making. • Overall architectural diagram with Blaze components and its integration with external applications.Number of entry points for the rule service and their signature. • Segment the project into discreet business tasks, and control the flow of execution so that specific tasks are executed in a particular sequence or when specific conditions are met. • Design of the execution/process flow for the service.Create Java/XML business Object model. • Select the appropriate Execution modes on project or entity level wherever required. • Create Deployment definitions. i.e. Rule Service Definition, Deployment Definition and System Definition. • Migrated legacy system like tuxedo,proC into FICO Blaze platform by converting business logic to rules. • Created design diagram and rule design for adjudication process on confluence.

Education

• Shivaji University

  Bachelor of Engineering (B.E.), Electronics And Tele-comm

  2008 — 2012

• Shivaji English School ,Pandurtitha

  HSC, Computer Science

  2008 — 2010