Sanjana Palankar, CSM

Experience

• 

  Deloitte and Touché LLP

  Jan 2008 - Jan 2012

  QA/SIT Tester

  TIERS- Texas Integrated Eligibility Redesign SystemTIERS is designed to create a state-of-the-art, web-based eligibility determination system for HHS programs. TIERS will provide HHS eligibility workers with a single, integrated system that will be used in delivering food, cash assistance, medical, and community care services to Texans in need. It also supports data sharing with other state agencies including the; Worked as Quality Assurance and System integration tester for TIERS project.

• 

  ACS/TMHP

  Apr 2012 - Nov 2012

  System Analyst

  April 2012 - Nov 2012 Xerox Pharmacy (ACS) Austin,TX Medicaid Managed Care Expansion (NCPDP D.0 HIPAA Upgrade for Texas Pharmacy claims application).The objective of this project is to upgrade the current version (NCPDP 5.1) of the pharmacy claims standard to NCPDP D.0 (and HIPAA X12 Version 5010) as mandated by federal government. The new set of standards regulate the electronic transmission of specific healthcare transactions, including eligibility, referrals, claims, and remittances.Effective March 1, 2012, most Medicaid clients and all Children’s Health Insurance Program (CHIP) clients are receiving their prescription drug benefits through the managed care service delivery model. The basic objective of this project is to deny the claims for clients enrolled in Medicaid managed care or CHIP, load the post adjudicated claims into the Texas Vendor Drug Online transaction database and submit the rebate invoices to drug manufacturers for the drugs used in the post adjudicated claims.Worked as Quality Assurance and System integration tester for Xerox Pharmacy project. Show less

• 

  Department of Veterans Affairs

  Dec 2012 - Feb 2014

  QA Tester

  Dec 2012 - March 2014 HCPS (Health Claims Processing System) Austin,TXThe Veterans Health Administration (VHA) Chief Business Office (CBO) Purchased Care is engaging with the Financial Service Center (FSC) in Austin to create a claims processing system to include web portals for the sites, civil hospitals, and non-VA Providers to enter referrals for the Fee Program. The FSC will receive process, adjudicate, pay, and document all medical claims for Veterans Integrated Service Network (VISN). Claims will be received via mail or Electronic Commerce/Electronic Data Interchange (EC/EDI) and loaded into the Healthcare Claims Processing System (HCPS). Show less

• 

  3M

  Feb 2014 - May 2014

  Quality Assurance Engineer

  Project: 3M Motor Vehicle System Application implementation for DRIVS - Driver Record and Issuance Verification System and MOVRS - Motor Vehicle Registration SolutionThe 3M DRIVS is a powerful and reliable software system that can respond to the high-volume demands or changing business rules of a motor vehicle agency.The software reduces the time to process and deliver driver licenses to customers by streamlining all functions into one complete application.

• 

  Texas Mutual Insurance Company

  Sept 2014 - now

  Quality Assurance Analyst

  Test the Claims Software and the Policy and Billing system to determine that all the requirements have been implemented correctly.Piloted the implementation of the Silk Central Test case management and automation server for the company.Performed the System testing, Regression testing and supported with UA testing.Facilitate discussion with the Business Analysts and Developers in Functional verification.Texas Mutual’s safety team works with your company to help protect your employees, and our dividend program provides rewards for keeping your workplace safe. It’s a powerful combination from the state’s leading provider of workers’ compensation insurance. Show less