Anisha Rajeevakshan
Atlanta
Summary
A successful IT Specialist with 15+ years of experience in various roles in application development as System analyst, Product owner, IT lead etc. along with software development and testing skills and mainframe technology expertise. A team player with: Healthcare domain expertise for more than 15+ years especially on claims processing/adjudication system Adept at bridging the gap between business needs and technical solutions. Experienced in Agile methodologies, requirements elicitation and translating technical concepts into easily understandable language. Excellent management and leadership skills. Proven ability to understand business problems and apply technology to formulate workable solutions. Excellent testing skills including Test plan preparation, execution and defect triaging. Expertise high volume data testing as part of application migration projects. Good exposure to all the SDLC phases and process documentation. Good exposure to Development, Production support & Maintenance of software Applications Expertise in COBOL, DB2, JCL, IMS DB, CICS, Changeman, Endevor and Debug Tools Excellent analytical and debugging skills. Good exposure to IBM Developer for z/OS (IDz), GitLab tools and Mainframe APIs. Expertise in designing, developing and testing various Mainframe applications. IBM DB2 Certification Exposure on WAW /RPC to support WSDL based web services
Overview
15
15
years of professional experience
Work History
Specialist II – Software Engineering
UST Global Inc
03.2024 - Current
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- System Technical Analyst & Application SME for CSBD WGS Claims POR project.
- Worked on sub-projects assigned to IBM/UST Global for WGS-Claims division.
- AHP Coupe project – WGS direct Model: Alternative Health Plan vendor providing member steerage through provider classification based on Copay.
- AHP Coupe project – Ameriben Model: Partnering with AmeriBen to manage administration following a typical JAA model.
- SSCR PRJ1906004: Small scale change request for correct group selection during service dates.
- Travel and Lodging: Benefit tracking for non-transplant travel claims.
- VA HB601/SB543 Behavioral Health Crisis Services: Regulations for mental health and substance use disorder benefits coverage.
- Health OS connectivity ChartHub Integration: Pend claims denied for medical records or itemized bill and provider qualifies for Chart hub.
- CSBD NICU Level of Care System: Managing members admitted to Neonatal Intensive Care.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
Specialist II – Software Engineering
UST Global Inc
03.2024 - Current
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- System Technical Analyst & Application SME for CSBD WGS Claims POR project.
- Worked on sub-projects assigned to IBM/UST Global for WGS-Claims division.
- AHP Coupe project – WGS direct Model: Alternative Health Plan vendor providing member steerage through provider classification based on Copay.
- AHP Coupe project – Ameriben Model: Partnering with AmeriBen to manage administration following a typical JAA model.
- SSCR PRJ1906004: Small scale change request for correct group selection during service dates.
- Travel and Lodging: Benefit tracking for non-transplant travel claims.
- VA HB601/SB543 Behavioral Health Crisis Services: Regulations for mental health and substance use disorder benefits coverage.
- Health OS connectivity ChartHub Integration: Pend claims denied for medical records or itemized bill and provider qualifies for Chart hub.
- CSBD NICU Level of Care System: Managing members admitted to Neonatal Intensive Care.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
Business Change Advisor
UST Global Inc
10.2023 - 02.2024
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- CSBD Change Management project: Creating new Business requirements based on Business stakeholders.
- Help IT to develop and meet the requirements.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
Business Change Advisor
UST Global Inc
10.2023 - 02.2024
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- CSBD Change Management project: Creating new Business requirements based on Business stakeholders.
- Help IT to develop and meet the requirements.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
Product Owner
UST Global Inc
06.2022 - 09.2023
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- Claims Re Imagine project: Handling a team of 25 resources.
- Successfully completed Membership validation process.
- Objective: Build next generation payer platform using a componentized model.
- Focus on Claims processing including Membership & claims validation, service code generation, clinical edits, & pricing.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
Product Owner
UST Global Inc
06.2022 - 09.2023
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- Claims Re Imagine project: Handling a team of 25 resources.
- Successfully completed Membership validation process.
- Objective: Build next generation payer platform using a componentized model.
- Focus on Claims processing including Membership & claims validation, service code generation, clinical edits, & pricing.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
Sr.System Analyst
UST Global Inc
04.2020 - 03.2022
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- NASCO Migration Project: Enhancement for migrating NASCO accounts to WGS.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
Sr.System Analyst
UST Global Inc
04.2020 - 03.2022
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- NASCO Migration Project: Enhancement for migrating NASCO accounts to WGS.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
System Analyst
UST Global Inc
10.2018 - 04.2020
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- WGS Claims Development Projects: Focus on existing system study, system to system impact analysis, enhancements, redesign architecture.
- Preparation of all system workflow diagrams in Anthem Claims processing Utilization management System.
- End to end processing of various types of Medical Claims.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
System Analyst
UST Global Inc
10.2018 - 04.2020
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- WGS Claims Development Projects: Focus on existing system study, system to system impact analysis, enhancements, redesign architecture.
- Preparation of all system workflow diagrams in Anthem Claims processing Utilization management System.
- End to end processing of various types of Medical Claims.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
System Analyst
UST Global Inc
11.2017 - 10.2018
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- WGS MSM for POR (Claims) 2017: Development work for SSCR, POR, CQ tickets.
- WGS Medicaid application handles enrollment, billing and claims processing of members under Medicaid business.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
System Analyst
UST Global Inc
11.2017 - 10.2018
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- WGS MSM for POR (Claims) 2017: Development work for SSCR, POR, CQ tickets.
- WGS Medicaid application handles enrollment, billing and claims processing of members under Medicaid business.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
Track Lead
UST Global Inc
12.2015 - 11.2017
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- ASO Billing Migration Project: WGS claims and financial systems interface with Check write and FCS/DMS.
- Migration of business assigned with some Fund Type from Check write to FCS.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
Track Lead
UST Global Inc
12.2015 - 11.2017
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- ASO Billing Migration Project: WGS claims and financial systems interface with Check write and FCS/DMS.
- Migration of business assigned with some Fund Type from Check write to FCS.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
Track Lead
UST Global Inc
08.2015 - 12.2015
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- SSCR 30716 WGS Missing Pair: Small-scale change request project dealing with Adjustment Claims.
- Prevents missing pair issues in FCS and avoids recycle of claims.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
Track Lead
UST Global Inc
08.2015 - 12.2015
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- SSCR 30716 WGS Missing Pair: Small-scale change request project dealing with Adjustment Claims.
- Prevents missing pair issues in FCS and avoids recycle of claims.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
Track Lead
UST Global Inc
08.2014 - 08.2015
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- WGS 2.0 Claims – HIX ODS: Health Insurance Exchange initiative to bring different WellPoint legacy and specialty system to have “single source of truth” accumulator storage.
- Create new DB and develop a process to update and Inquiry that DB for multiple systems.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
Track Lead
UST Global Inc
08.2014 - 08.2015
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- WGS 2.0 Claims – HIX ODS: Health Insurance Exchange initiative to bring different WellPoint legacy and specialty system to have “single source of truth” accumulator storage.
- Create new DB and develop a process to update and Inquiry that DB for multiple systems.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
Track Lead
UST Global Inc
02.2014 - 07.2014
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- WGS claims project planning: Planning phase includes activities required to come up with detailed requirements and approach for developing the requirements.
- Support as requested by the execution team for the rest of SDLC phases from design through implementation.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
Track Lead
UST Global Inc
02.2014 - 07.2014
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- WGS claims project planning: Planning phase includes activities required to come up with detailed requirements and approach for developing the requirements.
- Support as requested by the execution team for the rest of SDLC phases from design through implementation.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
Project Lead /Track lead
UST Global Inc
07.2012 - 02.2014
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- West Claims Pool Projects: Handles all changes related to WGS Claims Services and WGS Claims Prescreening activities.
- ITS12.0 Project: Support implementation of Blue Cross and Blue Shield Association ITS Release 12.0.
- Claims Customer Service Project: WGS Claims Services changes, data requests from different consumers.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
Project Lead /Track lead
UST Global Inc
07.2012 - 02.2014
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- West Claims Pool Projects: Handles all changes related to WGS Claims Services and WGS Claims Prescreening activities.
- ITS12.0 Project: Support implementation of Blue Cross and Blue Shield Association ITS Release 12.0.
- Claims Customer Service Project: WGS Claims Services changes, data requests from different consumers.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
Software Developer
UST Global Inc
04.2012 - 06.2012
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- Health Care Reforms: Mandate, highly visible and huge project.
- Achieved full compliance within PPACA deadlines and exceeded expectations.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
Software Developer
UST Global Inc
04.2012 - 06.2012
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- Health Care Reforms: Mandate, highly visible and huge project.
- Achieved full compliance within PPACA deadlines and exceeded expectations.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
Software Developer/Track lead
UST Global Inc
11.2011 - 04.2012
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- STAR Claims Retirement: Retire STAR claims processing application.
- Implementing online screen changes to update and inquire star membership along with WGS membership.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
Software Developer/Track lead
UST Global Inc
11.2011 - 04.2012
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- STAR Claims Retirement: Retire STAR claims processing application.
- Implementing online screen changes to update and inquire star membership along with WGS membership.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
Software Developer
UST Global Inc
04.2010 - 11.2011
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- STAR to WGS Migration: Process STAR claims on WGS 2.0 systems.
- Enhancements to WGS 2.0 system to process claims accurately for STAR members.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
Software Developer
UST Global Inc
04.2010 - 11.2011
- Company Overview: UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
- STAR to WGS Migration: Process STAR claims on WGS 2.0 systems.
- Enhancements to WGS 2.0 system to process claims accurately for STAR members.
- UST Global is a leading digital technology services company that provides advanced computing and digital solutions to large enterprises across the globe. Website: www.ust-global.com
Education
Bachelor of Engineering - Computer Science Engineering
Cooperative Institute of Technology
Vadakara, Kerala01.2009
Higher Secondary Course Certificate - undefined
Puliyaparamb Higher Secondary School
Palakkad, Kerala01.2005
Secondary School Leaving Certificate - undefined
Kanikkamatha English Medium School
Palakkad, Kerala01.2003
Skills
- VS COBOL II
- JCL
- SQL
- IMS DB
- DB2
- VSAM
- TSO/ISPF
- IOF
- Control-M
- SAR
- CHGMAN
- File Manager
- Fault Analyzer
- PD Tools
- EZYEDIT
- SUPERCE
- Teradata
- SPUFI
- QMF
- MVS OS390
- Z/OS
- Microsoft SharePoint
- Microsoft Office
- Jira
- IBM Rational
- Defect Tracking Tools
- System Analyst
- Product Owner
- IT Lead
- Application SME
Accomplishments
- Received ‘Inspire (d) People’ awards in Healthcare Domain in UST Global
- Received ‘Execution Mindset’ awards in Health Care Domain from UST Global
Skills Summary
VS COBOL II, JCL, SQL, IMS DB, Knowledge in DB2, VSAM, TSO/ISPF, IOF, Control-M, SAR, CHGMAN, File Manager, Fault Analyzer, PD Tools, EZYEDIT, SUPERCE, SPUFI, QMF, MVS OS390, Z/OS, Microsoft SharePoint, Microsoft Office, Jira, IBM Rational, Jira
Experience Highlights
UST Global Inc, http://www.ust-global.com, Atlanta, Atlanta, GA, 30301, USA, Specialist II – Software Engineering, Healthcare, CSBD WGS Claims POR, Development, Healthcare – WGS claims, 2024-03-01, present, System Technical Analyst & Application SME, Atlanta, Atlanta, GA, 30301, USA, CSBD Change Management, Business, 2023-10-01, 2024-02-29, Business Change Advisor, Atlanta, Atlanta, GA, 30301, USA, Claims Re Imagine, Development, 2022-06-01, 2023-09-30, Product Owner, Atlanta, Atlanta, GA, 30301, USA, NASCO Migration Project, Development, 2020-04-01, 2022-03-31, Sr.System Analyst, Atlanta, Atlanta, GA, 30301, USA, WGS Claims Development Projects, Development, 2018-10-01, 2020-04-30, System Analyst, Atlanta, Atlanta, GA, 30301, USA, WGS MSM for POR (Claims) 2017, Development, 2017-11-01, 2018-10-31, System Analyst, Woodland Hills, Woodland Hills, CA, 91367, USA, ASO Billing Migration Project, Development, 2015-12-01, 2017-11-30, Track Lead, Kerala, Kerala, Kerala, 00000, India, SSCR 30716 WGS Missing Pair, Development, 2015-08-01, 2015-12-31, Track Lead, Kerala, Kerala, Kerala, 00000, India, WGS 2.0 Claims – HIX ODS, Development, 2014-08-01, 2015-08-31, Track Lead, Kerala, Kerala, Kerala, 00000, India, WGS Claims Project Planning, Planning, 2014-02-01, 2014-07-31, Track Lead, Kerala, Kerala, Kerala, 00000, India, West Claims Pool Projects, Development, 2012-07-01, 2014-02-28, Project Lead /Track lead, Kerala, Kerala, Kerala, 00000, India, Health Care Reforms, Development, 2012-04-01, 2012-06-30, Software Developer, Kerala, Kerala, Kerala, 00000, India, STAR Claims Retirement, Development, 2011-11-01, 2012-04-30, Software Developer/Track lead, Kerala, Kerala, Kerala, 00000, India, STAR to WGS Migration, Development, 2010-04-01, 2011-11-30, Software Developer, Kerala, Kerala, Kerala, 00000, India
Training
- 2009-11-01, 2010-02-28, Mainframe, Escube Technologies, Trivandrum, NA
- 2010-12-01, 2010-12-31, IBM Certified Database Associate DB2 9 Fundamentals, IBM, DB2
Timeline
Specialist II – Software Engineering
UST Global Inc
03.2024 - Current
Specialist II – Software Engineering
UST Global Inc
03.2024 - Current
Business Change Advisor
UST Global Inc
10.2023 - 02.2024
Business Change Advisor
UST Global Inc
10.2023 - 02.2024
Product Owner
UST Global Inc
06.2022 - 09.2023
Product Owner
UST Global Inc
06.2022 - 09.2023
Sr.System Analyst
UST Global Inc
04.2020 - 03.2022
Sr.System Analyst
UST Global Inc
04.2020 - 03.2022
System Analyst
UST Global Inc
10.2018 - 04.2020
System Analyst
UST Global Inc
10.2018 - 04.2020
System Analyst
UST Global Inc
11.2017 - 10.2018
System Analyst
UST Global Inc
11.2017 - 10.2018
Track Lead
UST Global Inc
12.2015 - 11.2017
Track Lead
UST Global Inc
12.2015 - 11.2017
Track Lead
UST Global Inc
08.2015 - 12.2015
Track Lead
UST Global Inc
08.2015 - 12.2015
Track Lead
UST Global Inc
08.2014 - 08.2015
Track Lead
UST Global Inc
08.2014 - 08.2015
Track Lead
UST Global Inc
02.2014 - 07.2014
Track Lead
UST Global Inc
02.2014 - 07.2014
Project Lead /Track lead
UST Global Inc
07.2012 - 02.2014
Project Lead /Track lead
UST Global Inc
07.2012 - 02.2014
Software Developer
UST Global Inc
04.2012 - 06.2012
Software Developer
UST Global Inc
04.2012 - 06.2012
Software Developer/Track lead
UST Global Inc
11.2011 - 04.2012
Software Developer/Track lead
UST Global Inc
11.2011 - 04.2012
Software Developer
UST Global Inc
04.2010 - 11.2011
Software Developer
UST Global Inc
04.2010 - 11.2011
Bachelor of Engineering - Computer Science Engineering
Cooperative Institute of Technology
Higher Secondary Course Certificate - undefined
Puliyaparamb Higher Secondary School
Secondary School Leaving Certificate - undefined
Kanikkamatha English Medium School