Streamlined and Modernized Claims Repricing System
Data & Analytics
Client Profile:
Multiplan- A nationwide healthcare cost management organization
Scope:
- Customized claim repricing system- PPO Repricing, Cost-Based Fee Negotiation Services, and Reference Based Repricing
- Developed proprietary routing optimization to achieve maximum savings
- Integrated regional PPO networks through a single interface
- Developed scalable data pipelines and build out new API integrations to support continuing increases in data volume and complexity.
Model:
Fixed Price and Strategic Staffing
Keywords :
Core Java, Weblogic, JavaScript (React JS+/ Angular/ NodeJS), Spring Framework, SQL, Linux, Tomcat, EJB, Containerization, Kafka, SQL Loader