Gouri

Healthcare RCM Business Analyst with 2 years of experience documenting business requirements for HL7 and FHIR-based healthcare information exchange within Epic (EMR/EHR) environments. Skilled in BRD/FRD documentation, gap analysis, HIPAA-compliant requirement gathering, and Agile delivery. Track record of reducing turnaround time, improving billing accuracy, and recovering revenue through data-driven process re-engineering and close collaboration with healthcare stakeholders.

Business Analyst, Healthcare (RCM) - PwC - Bangalore

(2024-05 - 2026-05)

• Reduced claims processing turnaround time by 22%, as measured by SLA compliance reports, by leading requirement analysis and workflow assessments across the end-to-end RCM claims lifecycle — including claims processing, member enrollment, and provider management — within Epic (EMR/EHR).
• Improved billing accuracy by 18%, as measured by reduction in denial rate, by documenting BRDs, FRDs, and process flow diagrams for HL7/FHIR-based healthcare information exchange requirements in partnership with cross-functional Agile teams during sprint planning and stand-ups.
• Recovered 12–15% in revenue leakage, as measured by claims resolution reports, by analyzing denials, underpayments, and overpayments across the billing and revenue cycle and translating findings into actionable process fixes.
• Cut requirement rework by 30%, as measured by fewer change requests post-sign-off, by conducting stakeholder workshops and requirement elicitation sessions, and performing gap analysis to validate business needs against Epic system capabilities and HL7/FHIR interoperability standards.
• Maintained audit-ready healthcare information exchange (HIE) requirements, as measured by zero audit findings across two review cycles, by reviewing requirements and system outputs against HIPAA, HL7, FHIR, ICD-10, and CPT guidelines.
• Supported UAT execution, defect tracking, and production deployments across 12 releases, as measured by on-time go-live delivery, by coordinating with developers and QA teams to validate HL7-driven claims processing, member enrollment, and provider management workflows.
• Delivered weekly KPI dashboards tracking SLA compliance and claims quality benchmarks, as measured by stakeholder adoption across three business units, by building reports in SQL, Excel, and Tableau/Power BI for leadership review.

Business Development Intern - Zuooa - Ranchi

(2024-01 - 2024-05)

• Shortened client requirement-gathering cycles by 25%, as measured by faster proposal turnaround, by translating business needs into actionable insights during discovery calls.
• Grew qualified B2B pipeline by 120 leads, as measured by opportunities advanced to proposal stage, by conducting market and competitor analysis.
• Improved proposal win alignment by 15%, as measured by client feedback scores, by supporting stakeholder communication and aligning solution design with client expectations during negotiation and deal closure.

Bachelor's of Commerce Hons. (Vocational) - Specialization in Marketing & Advertising - St. Xavier's College, Ranchi (2021-05 - 2024-05)