Healthcare Data & Analytics Specialist with ETL Expertise

Charishma Boppa

+1-205-***-**** *********.***@*****.*** www.linkedin.com/in/charishma-boppa-9604143a3

PROFESSIONAL SUMMARY

•Healthcare data and business analyst with 4 years of experience extracting, reconciling, and modelling claims, member, and provider data using SQL, PL/SQL, Tableau, and Facets to reduce claim denials, improve adjudication accuracy, and optimize reimbursements.

•Led ETL design and data integration for PBM, Medicare, and Medicaid pipelines using SQL and Python, creating validations, automations, and monitoring that reduced ETL failures and improved downstream reporting reliability.

•Built interactive Tableau and Power BI dashboards for claims trends, provider networks, and financial reconciliation, enabling leaders to identify cost drivers and support interventions that lowered monthly variance.

•Implemented HIPAA-aligned governance and EDI (837/835) and HL7/FHIR mapping and validations to ensure compliance, streamline eligibility checks, and reduce claims adjudication cycle time.

•Experience supporting regulated healthcare data analytics and data migrations in compliance-driven environments

•Strong background in Oracle SQL–based analysis, data validation, and SDLC-driven delivery

•Converted business requirements into BRD/FDD and functional specs, led UAT and regression testing, and tuned Facets Claim and Provider configuration to increase processing accuracy and shorten deployment cycles.

•Automated reporting and UI tests using VBA, Selenium, and AWS Step Functions to accelerate testing, improve data quality, and free analyst time for advanced analytics and business improvement initiatives.

KEY SKILLS

•Languages & databases: SQL, T-SQL, PL/SQL, Python, R, SAS, Oracle, SQL Server, Snowflake, Redshift, Big Query.

•BI & visualization: Tableau (Advanced Certified), Power BI, Looker, OBIEE.

•ETL / data platforms: Informatica PowerCenter, AWS Step Functions, ETL frameworks, data pipelines, data warehousing, MDW.

•Healthcare systems & standards: Facets, EDI X12 (837/835/270/271), NCPDP, HL7, FHIR, ICD-10, Medicare/Medicaid workflows, PBM.

•Methodologies: SDLC Agile, UAT, data validations, and reconciliation

•Companies and regulated data: HIPAA, controlled healthcare datasets, audit-ready validation

•Client-facing skills: stakeholder communication, requirements clarification, delivery support

•Automation & testing: VBA (MS Access), Selenium WebDriver, UI automation, API testing, test case creation, UAT.

•Other tools: Excel (advanced + VBA), DBeaver, SQL Developer, TOAD, Visio, GitHub, Linux/Unix shell scripting.

Soft Skills: Communication & Stakeholder Management, Analytical thinking and attention to detail, Prioritization and time management, Team mentoring and knowledge transfer, Problem-solving and adaptability in Agile environments, Business storytelling and data-driven decision support.

WORK EXPERIENCE

Healthcare Data Analyst Feb 2024 – Present UAB Medicine Birmingham, AL

•Managed provider, network, and agreement data mapping in Facets and wrote optimized SQL queries to reconcile fee schedules, which corrected payment errors and improved provider payment accuracy by measurable margins.

•Orchestrated ETL validation between cloud warehouses and MDW using SQL and Python, implementing data quality checks that reduced pipeline failures and improved report timeliness for claims analytics.

•Configured and tested Claims and Provider modules in Facets for new networks and agreements, executing claims testing that validated benefit rules and avoided potential reimbursement discrepancies.

•Automated claims validation scripts and Excel/VBA processes to reconcile large fee schedule sets, reducing manual reconciliation time and improving monthly close efficiency.

•Designed and published Tableau dashboards for claims trend analysis and network performance, enabling operations to identify cost drivers and support corrective action that decreased claim variance.

•Supported regulated healthcare data migrations and validations, ensuring accuracy, traceability, and compliance with governance standards

• Worked directly with business and operational stakeholders to validate data, explain analytical findings, and support decision-making

•Executed end-to-end SDLC activities, including requirements gathering, testing, validation, and production support for analytics deliverables

•Performed EDI 837/835 testing and HL7/FHIR validations to ensure accurate transaction processing, speeding adjudication and reducing remittance-related discrepancies.

•Authored functional specifications and FDD, partnered with technical teams during sprint cycles, and led UAT to deliver Facets configuration changes with minimal production defects.

•Led provider enrolment and member eligibility verification workflows, deploying SQL-based checks that improved enrolment accuracy and reduced downstream claim rejections.

•Executed root cause analysis on claims exceptions and tuned database queries and indexes, enhancing query performance and accelerating analytical turnaround for management reporting.

Business / Data Analyst Sep 2021 – Jul 2023 Capgemini Hyderabad, India

•Analyzed EDI transaction sets and validated HIPAA 837/835 flows to fix settlement errors, improving EDI throughput and reducing adjudication exceptions in targeted provider cohorts.

•Gathered requirements and modelled transactional sources into a data warehouse schema, enabling reliable ETL and accurate downstream analytics for utilization and cost reports.

•Conducted JAD sessions and facilitated stakeholder alignment to clarify BRD items, accelerating developer delivery of reporting features and reducing rework cycles.

•Developed Python scripts to parse JSON and load claim metadata into staging tables, automating ingestion and decreasing manual loading tasks for recurring reports.

•Built ad hoc and scheduled reports using Python and SQL to monitor incident and cost trends, enabling management to prioritize corrective actions and resource allocation.

•Converted legacy SAS routines to Python and SQL for recurring analyses, lowering runtime and simplifying maintenance while retaining analytical fidelity.

•Performed quality checks, data profiling, and reconciliation to ensure accuracy of warehouse extracts used for regulatory and client reporting.

EDUCATION

Master’s in Data Science from Lindsey Wilson University, TN, USA

Bachelor's in Computer Science from Gudlavalleru Engineering College, JNTU-K

PROJECTS

Claims Cleanse Healthcare project

Project description: Academic capstone simulating Medicare claim workflows and ETL pipelines; focused on data validation, reconciliation automation, and stakeholder-ready reporting.

•Validated simulated Medicare claims using SQL and Excel macros to find mapping errors, corrected ETL logic, and coordinated a 3-member student team to reduce daily reconciliation discrepancies by 35%.

•Automated month-end reconciliation using VBA templates and SQL checks, replaced manual steps and coached peers, cutting processing time by 40% and improving audit traceability for premium billing.

•Prepared UAT scripts and led peer testing sessions to validate reconciliations and ETL fixes, logged defects, and coordinated fixes with developers, ensuring reprocessed batches met SLA and improved data quality.

•Presented findings and produced BRD-style documentation for stakeholders, drove process changes with teammates, and enabled sustained improvements in reconciliation accuracy and analyst productivity.

Claims Cleanse Insurance project

Project description: Course project harmonizing provider/product code sets and testing EDI ingestion; emphasized cross-team coordination, EDI validation, and month-end billing automation.

•Developed provider–product crosswalk tables and harmonized test code sets using SQL, coordinating a 4-member student group to update ingestion mappings and reduce provider lookup exceptions by 46% in validation runs.

•Executed EDI 837/835 sample validations and portal ingestion tests, documented defects, worked with peers to prioritize fixes, and validated reprocessed batches to restore claim ingestion accuracy within SLA windows.

•Designed test cases and led UAT cycles in mock environments, mentored teammates on EDI handling, and reduced reconciliation variance by 30% through targeted mapping corrections and process adjustment.

•Created automated Excel/VBA scripts for premium reconciliation, trained peers on templates, improved month-end billing accuracy, and cut reconciliation time while enhancing audit readiness.

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