Vigneshwaran Anandan

Data Analyst @United Healthcare Group - Australia

US

Developed and automated SQL queries to extract and analyze claims, payments, and provider data from AWS Redshift and Snowflake to detect inconsistencies and suspicious activity patterns.• Built predictive models using Python (scikit-learn) to classify claims as potentially fraudulent based on cost anomalies, frequency, and provider behavior metrics.• Created interactive Power BI dashboards that monitored high-risk providers, financial KPIs, and suspicious claims across different regions, aiding internal audit and compliance teams.• Cleaned, transformed, and validated over 5 million records per month using Pandas and NumPy, ensuring high data quality and regulatory compliance under HIPAA standards.• Applied financial risk modeling techniques to evaluate claim payout patterns and identify deviations from expected cost thresholds.• Conducted trend and variance analysis on claims costs, provider reimbursements, and patient care episodes to generate insights for reducing operational inefficiencies.• Collaborated with cross-functional teams (underwriters, finance analysts, and legal) to design reporting solutions tailored to fraud mitigation and financial audit requirements.• Documented data dictionaries, process flows, fraud detection logic, and participated in UAT testing to ensure systems met business requirements and audit readiness.

Sri Sairam Engineering College

Bachelor's degree, Mechanical Engineering

Great Learning

Postgraduate Degree, Data Science and Engineering

California State University - East Bay

Master's degree, Statistics