Facets is a claim validation system through which claims are passed and validated against the various business rules. We gets EDI filesfor electronic claims like 837, 834, 835. We have to convert these files in X12 format and load in Facets

This project is an ETL Testing project where we test the migration of data from one database to another. We have different subject areas like Medication, Authorization, House Calls, Member Demo etc. and we also validate the functionality of these subject areas on Pathway UI Application.

This project is for Testing different insurance products like creating proposals by agent for different organizations, Smart Quote and Genelco. We also have an application which allows end user to elect different insurance options as per their eligibility.

This project implemented which deals with health and benefit plans elections for the employees of their organization once a year. Employees logon to the Website(YBR) and make their elections for Health Insurance. There are lot of updations made in this project like adding new insurance option, deleting some insurance plan, updating the cost of insurance plan, changing the eligibility for a particular Insurance Plan etc. After all the changes we test the website whether it’s working as expected or not.

We have an application with name CDB where we enter some basic information like Name, Age, DOB etc of a consumer and fetch the data based on the inputs given. We have created different views based on different combination of inputs to fetch the Consumer data. This is application is created for the ease of Customer as its not easy to directly fetch the data from DB2 tables.

This project is to process the Claims submitted by members or providers. We get the claim data that is passed to the Payment Engine gateway and then certain Business Rules are applied on that data. Based on the validation rules Claims are accepted or rejected. We have two modes of Claim Payment- One is Electronic and another one is through Cheque or Paper. We have different modules like Common Claim Intake, Common On Ramp , PRA, Release Processing etc.

This project implemented for validation of claims submitted by the third party or provider to payor for detecting the fraud claims.

Website Up gradation

Airline Domain

Automobile Domain

HR Domain