Soumya Raj

A highly organized and hardworking individual looking for a responsible position to gain practical experience and to achieve goals of company that focuses on customer satisfaction and experience. IT Business Analyst in US Healthcare domain particularly in Health Care for prioritizing and write high level user stories. Experienced with agile project management, requirements gathering, BRDs/Mock-up creation and stakeholder engagement.

Utilizes these skills to streamline product development and ensure alignment with business objectives. Track record of effective communication and team leadership, driving successful product launches and continuous improvement.

Business Analyst/Product Owner at Infosys (2024-01 – Present)

• BA/PO/SM at Blue Cross Blue Shield; prioritized backlog and aligned with business goals.
• Applied Agile practices, developed product roadmaps, and collaborated with cross-functional teams.
• Facilitated Scrum ceremonies (planning, grooming, stand-ups, reviews, retrospectives).

Business analyst at Carelon Global Solutions LLP (2022-01 – 2024-12)

• Senior Business Analyst at Anthem; managed requirements, JIRA backlog, and user stories/BRDs. Strong in Medicaid/Medicare, CMS, HIPAA, EHR/EMR.
• Led JAD sessions and conducted UAT to ensure business alignment.

Senior Appeals Specialist- Denial Management at Prim Era Medical Technologies Pvt. Ltd (2021-01 – 2022-12)

• Experienced in Medicare and Medicaid reimbursement in U.S. healthcare.
• Reviewed denied claims and prepared appeals using clinical documentation and CMS guidelines.
• Evaluated medical necessity and ensured coding/billing accuracy.
• Analyzed denial trends and collaborated with providers to improve processes.
• Ensured HIPAA compliance and supported team training.

Resident doctor at Manipal Superspeciality Hospitals (2011-01 – 2021-12)

• Worked as Resident doctor in various departments (ICU/OP/Wards)
• Managed patient care, diagnosis, and treatment in clinical settings
• Assisted procedures and supported emergency care
• Collaborated with healthcare teams and maintained records

Bachelor of Medicine and Bachelor of Surgery in Medicine – Luzhou Medical University (2004-01 – 2010-12)