Ramkumar Gopalakrishnan

Background

About Ramkumar Gopalakrishnan

EDI/ X12 expertise, ACA HIX project experience 14 years of Experience in all kinds of manual Testing, leading the testing team, Requirement analysis, 4+ years of experience in Medicaid and also experience in ACA HIX project. Strong Healthcare EDI X12 experience and play a role of a EDI SME for the project. Strong HIX functional knowledge of 834 and 820 transactions within ACA. Experience in working on X12 transactions related to Eligibility Verification (270, 271), Authorization (278), Claims (837), Claims Status Inquiry (276, 277) Experience in Business Analysis Vast experience as a Test Lead and leading the testing team. Worked in the successful EDI Implementation for the project using EDIFECS product. Worked in various Functional areas in APHP project like Provider Enrollment & Maintenance, Member Enrollment and Maintenance, PCP Assignment, Prior Authorization & Claims. Work Experience older than 3 years: Experience in Health Insurance (2yrs) and Life Sciences (4yrs) domain. Good amount of exposure in Health Insurance projects towards ETL/ DB testing using Informatica, Compensation calculation tool (TrueComp) to pay Agents/Brokers. SME in one of the Adverse Event Reporting System in LS domain