Claims Auto-Adjudication, EDI Integration
MedSpecialized
Jul 2018 - Sep 2022 (4 years 3 months)
As a Claims Auto-Adjudication, EDI Integration specialist, I was responsible for designing and implementing robust systems that streamlined the claims processing workflow. My role involved extensive data modeling and the application of event-driven architecture (EDA) to enhance system responsiveness and efficiency. I utilized query optimization techniques to ensure high-performance data retrieval and integrated REST APIs for seamless communication between services. Additionally, I employed asynchronous programming to improve system throughput and responsiveness. A significant project I led at MedSpecialized involved the development of an AI-powered pipeline that orchestrated OCR extraction, rule-based classification, and scoring across vari