Rinold A. A
Operations & Business Analyst | Data Validation & Process Coordination
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About
Operations and process analyst with 1+ year of experience in a healthcare-insurance environment, handling HIPAA-compliant verification, eligibility and benefits validation, and cross-referencing of policy documentation for data accuracy and regulatory compliance. MCA graduate with hands-on technical grounding in SQL, Power BI, Excel, and Python, seeking to apply analytical and process-coordination skills in a Business/Operations Analyst role.
Experience
AI Operations Analyst (AI Operations Trainee) at Xtransmatrix Consulting Services Pvt. Ltd. (2025-07 – 2026-09)
US-Based Healthcare AI Operations Project
- Performed HIPAA-compliant verification of patient identity and case details with insurance agents before any information exchange, in line with data-privacy and compliance requirements.
- Gathered and validated patient eligibility and benefits (E&B) information, including plan coverage, drug coverage status, and cost-share structure (copay, coinsurance, deductible), directly from insurance payers.
- Cross-referenced payer-provided information against policy and plan documentation to catch discrepancies and ensure data accuracy before it reached downstream teams.
- Operated within both agent-handled and AI-assisted (human-in-the-loop) call workflows using structured, pre-built prompts, and reviewed AI-generated responses for accuracy, flagging inconsistencies as part of quality checks.
- Followed defined SOPs and quality standards across all cases, and identified recurring process bottlenecks that supported workflow improvements and reduced case turnaround time.
Education
MCA – Master of Computer Applications – St. Aloysius Institute of Management and IT (2024)
BCA – Bachelor of Computer Applications – SDM College of Business Management (2022)
PUC – St. Aloysius Pre-University College (2019)
SSLC – Besant English School (2017)
