Veerender Kanchumarthi
Spring City,PA
Summary
Highly accomplished Senior Business Analyst and Program Manager with over 12 years of experience in healthcare IT. Specializing in revenue cycle management, provider credentialing, and EHR implementation/optimization, I lead large-scale medical billing and IT projects to streamline operations, reduce delays, and improve cash flow while ensuring HIPAA compliance. Skilled in end-to-end business analysis, including requirements gathering, workflow analysis, system customization, and driving digital transformation. Proficient in SQL, Power BI, and Jira, I bridge clinical and IT teams. My expertise extends to working knowledge of Property & Casualty (P&C) Insurance fundamentals and exposure to core insurance platform concepts (e.g., policy administration, claims lifecycle, billing), complementing deep healthcare operations acumen.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Senior Business Analyst
Rite Aid
07.2024 - 05.2025
- Facilitated requirement gathering with clinical and IT stakeholders, documenting clear business requirements for pharmacy system enhancements.
- Led end-to-end delivery of provider data onboarding, credentialing, and directory publishing solutions.
- Defined and prioritized user stories and requirements in collaboration with cross-functional teams.
- Integrated provider systems with downstream claims, member services, and analytics platforms.
- Led UAT execution and secured stakeholder sign-offs, ensuring data quality and business readiness.
- Maintained system documentation and Confluence knowledge base for implementation and operations.
- Drove initiatives for data quality improvement, duplicate record reduction, and golden source strategies.
Program Manager – Revenue Cycle Management
Advantum Health Pvt Ltd
03.2021 - 01.2022
- Directed a 50-member team across full-cycle RCM operations, including billing, AR, and patient coordination.
- Achieved 96.5% clean claim rate and reduced AR days to below 45 through workflow optimization.
- Collaborated with stakeholders to define business needs and translate them into system requirements and user stories.
- Developed Excel-based KPI dashboards to track operational performance and claims trends.
- Supported EHR-integrated billing system implementation and validated claims adjudication logic via UAT.
- Ensured regulatory compliance and HIPAA alignment through process realignment.
- Met with project stakeholders on regular basis to assess progress and make adjustments.
- Interacted with customers and clients to identify business needs and requirements.
- Coached team members on productivity strategies to accomplish challenging goals.
- Addressed and resolved technical, financial, and operational concerns by working with team members and directors.
- Engaged and worked alongside cross-functional stakeholders to manage strategic initiatives.
- Demonstrated strong writing and presentation skills to develop briefs, memorandums and analytical reports for clients.
- Managed multiple strategic projects with numerous sub-projects or workstreams.
- Managed and supervised administrative and daily program operations, complying with policies and regulations.
- Leveraged project management processes and tools to define and execute projects.
Operations Analyst – Revenue Cycle Training
Optum Global Solutions (UHG)
09.2020 - 03.2021
- Designed and delivered training on payer rules, claims workflows, and billing procedures to RCM teams.
- Built training outcome trackers and dashboards using Excel (pivot tables, formulas, VLOOKUP).
- Partnered with QA and HR to align SOPs and training with audit and quality standards.
- Gained exposure to Property & Casualty (P&C) claims processing and policy administration concepts supporting diversified insurance operations.
- Reduced onboarding time by 30% while achieving 90%+ training success rates.
- Designed plans to improve operations and suggested changes to systems for overall organization.
- Worked with engineers and technical staff to recommend hardware and software adjustments and resolve design flaws.
- Conducted data analysis to identify opportunities for streamlining client operations and improving customer satisfaction.
- Supported supervisor and associated team members to maintain system functionality.
- Analyzed trend data to forecast operational needs and plan next course of action.
Assistant Manager
Optum Global Solutions (UnitedHealth Group)
10.2018 - 07.2020
- Led a team of 30 responsible for claims adjudication and appeals management under strict SLA guidelines.
- Automated backlog and production reports using Excel, improving claim visibility and resolution speed.
- Implemented process improvements and CAPAs in partnership with QA to enhance quality outcomes.
- Supported operations involving core insurance claims platforms and processes common in Property & Casualty (P&C) lines.
- Oversaw performance coaching, staffing allocation, and team productivity management.
- Reduced aged claims backlog by 35% and increased team efficiency by 22%.
- Participated in UAT cycles for claims system updates, providing end-user feedback for fixes.
- Completed regular inventory counts to verify stock levels, address discrepancies, and forecast future needs.
- Offered hands-on assistance to customers, assessing needs, and maintaining current knowledge of consumer preferences.
Business Analyst
Elico Healthcare Services
10.2016 - 08.2018
- Company Overview: India
- Documented requirements for Medicare Advantage enrollment, EHR enhancements, and provider workflows.
- Authored 100+ BRDs/user stories in Azure DevOps for Agile project teams.
- Created as-is/to-be process maps (Visio) and led gap analysis for compliance and operational improvements.
- Reduced enrollment processing time by 15% through test case development and defect resolution.
- Delivered $150K in cost savings through automation and workflow redesign.
- Facilitated UAT, data validation, and business reviews for provider onboarding modules.
- India
Senior Process Analyst
Elico Healthcare Services
07.2014 - 09.2016
- Company Overview: India
- Wrote BRDs and functional specs for provider system enhancements and EHR tools.
- Conducted Lean-based process modeling and optimization to improve adoption and cut delays.
- Delivered structured training to over 50 staff and led SOP rollout across teams.
- Developed SQL and Excel-based reports to track service quality and identify gaps.
- Supported Agile ceremonies, sprint planning, backlog creation, and test case reviews.
- Resolved system bottlenecks and ensured continuous improvement through feedback loops.
- India
Sr. Revenue Cycle Analyst
Sutherland Global Solutions
08.2012 - 05.2014
- Company Overview: India
- Delivered system training and SOP documentation across billing, AR, and claims functions.
- Participated in Agile development cycles, collaborating with developers during backlog refinement.
- Created defect logs and resolved test scenarios during UAT.
- Presented sprint updates, participated in scrums, retrospectives, and sprint planning.
- Led metrics analysis and presented outcomes to senior stakeholders for process improvement.
- India
Revenue Cycle Analyst
Sutherland Global Solutions
12.2010 - 07.2012
- Company Overview: India
- Managed hospital billing operations and followed up on claims to ensure reimbursement.
- Acted as SME for AR processes, payer policies, and documentation best practices.
- Streamlined claim submission procedures, improving processing speed and acceptance rates.
- Supported denial resolution processes to meet SLA and TAT targets.
- Increased claim acceptance by 18% and reduced processing time by 10%.
- India
Education
Master of Science - Computer Science
Campbellsville University
Louisville, KY01.2024
Bachelor of Technology - Computer Science
SRM University
Tamil Nadu, India01.2009
Skills
- EDI Transactions
- Business Analysis Tools
- SDLC Methodologies
- Project Management Tools
- Documentation
- Testing & Quality Assurance
- Healthcare Systems
- Data Management
- Collaboration Tools
- Process Improvement
- Programming Basics
Certification
Certified Scrum Product Owner (CSPO)
Timeline
Senior Business Analyst
Rite Aid
07.2024 - 05.2025
Program Manager – Revenue Cycle Management
Advantum Health Pvt Ltd
03.2021 - 01.2022
Operations Analyst – Revenue Cycle Training
Optum Global Solutions (UHG)
09.2020 - 03.2021
Assistant Manager
Optum Global Solutions (UnitedHealth Group)
10.2018 - 07.2020
Business Analyst
Elico Healthcare Services
10.2016 - 08.2018
Senior Process Analyst
Elico Healthcare Services
07.2014 - 09.2016
Sr. Revenue Cycle Analyst
Sutherland Global Solutions
08.2012 - 05.2014
Revenue Cycle Analyst
Sutherland Global Solutions
12.2010 - 07.2012
Master of Science - Computer Science
Campbellsville University
Bachelor of Technology - Computer Science
SRM University
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