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Healthcare / Reporting & data · PRIOR PROFESSIONAL WORK

More reliable healthcare eligibility data

Field mapping and validation for healthcare member and eligibility files, with a clear stop and correction process.

MY ROLE

I mapped source fields and built incoming file validation and data quality rules.

The problem

Healthcare member and eligibility data needed more reliable ingestion so downstream workflows received clean, consistent records.

What I did

  • Mapped source fields into the receiving system for EDI 834, CSV, and other flat files.
  • Built validation for member IDs, eligibility dates, invalid values, and file structure.
  • Stopped invalid files and generated an alert to the appropriate inbox so the sender could correct and resend them.

How the team used it

  • Keep bad data from moving into downstream eligibility workflows.
  • Give senders a clear correction and resubmission path.

WHAT CHANGED

Improved data cleanliness, consistency, successful ingestion, and reliability of downstream eligibility workflows.

Relevant services

CONNECTED EXPERIENCE

More work to explore.

Illustrative reconstruction based on the workflow I built or managed. No client data shown.

LET'S MAKE THE WORK EASIER.

A clearer process.
A system that works.

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