ABHISHEK GUPTA (+91) 706 523 0333 https://www.linkedin.com/in/abhishekgupta86

Education

Indian Institute of Management, Calcutta 2014–2015

Post Graduate Diploma in Management for Executives (MBA)

International Immersion at Mannheim Business School, Germany

Jamia Millia Islamia University, New Delhi 2004–2008

B Tech. Electronics & Communication

Technologies

Business Applications: MS Office Suite, Visio, SharePoint, Macro & Analysis Tool Pack

Analytics Tools: Tableau, SAS, R, VBA, XlS, SQL, MS Access

Software Technologies: Core Java, J2EE, Webservices, XML, XSD, Apache apis

WORK EXPERIENCE

EXL Service (Inductis) 2015 - Present

Business Process Services company provides decision analytics, operations management, and technology services

Manager – Decision Analytics 2015 (April) - Present

Managing Medical Claim Review process transformation as a part of acquisition integration and synergy

savings for 2nd

largest health insurance provider in the US

Responsible for identifying analytics opportunities, process automation & re-engineering oppourtunities,

stakeholder analysis, communication & training plan, and staff optimization

Conducted interviews for requirements gathering, prepared business requirements documents, process flow &

data flow diagrams, and assessed IT applications portfolio changes

Additional analytics activities and business development initiatives

Worked on Provider based segmentation, Medical claims volume forecasting, Fraud- Waste-Abuse Analysis,

and process level dashboards in Tableau

Worked on HEDIS measures reporting solution architecture and productization scope. This involved analysing

raw data sources, workflow designs, statistical models & algorithms, and rule engine design

Responsible for leading Business Process Analytics initiatives for Clients operation at Manila centre

Developed medical claims dashboard in Tableau, segmentation analysis by provider & markets, and procedure

codes billed amount outlier analysis in Specialty pharmacy project

Developed “End-of-Life” population analytics framework and predictive modelling solution approach for

business development activity

Prepared analytics opportunities proposal for Clinical Review Process, HEDIS Reporting, and Pre-

Certification Process with objective to improve profitability and streamline business process

Domain knowledge of the US medical claims/billing, medical billing RCM process, specialty pharmacy

medical claims and diagnosis & procedure coding standards ( CPT/HCPCS/ICD- 10)

Tata Consultancy Services 2008 - 2014

Consulting and IT services provider, ranks among top 10 global IT services companies

Solution Architect – US Healthcare 2012 – 2014(U.S)

Analysed business needs in presales projects in retail pharmacy domain and advised clients on build/buy

decision and provided development estimates

Led team of 6 members to conduct proof of concepts to validate technical feasibility of business requirements

Designed application workflow through feedback from operations team for client, Fortune 14th US based

pharmacy service provider with 7000+ stores

Gathered business requirements from client for project and presented technical implementation solutions

proposals

Developed solution architecture including High-level design documents and reviewed Business requirements

documents, Application design documents, Use-case

Team Lead 2010-2012(U.S)

Led a10 member onsite/offshore software development team, which delivered major project releases to

improve operational efficiency for the client

Developed design strategy for IT integration and data availability across core business applications in four

Lines of Businesses of the client

Engaged in developing project resource capabilities through knowledge sessions on Retail Pharmacy domain

knowledge

Software Designer 2008-2010 (India)

Designed and developed business rules for an online insurance billing request validation engine that prevents

claims rejection

Performed static code analysis on project code base to provide estimation of technical debt and the effort

required for debt reversal

ADDITIONAL INFORMATION

Visa Info Valid US- B1visa and Philippines 9(A) multiple entry visa

Interests

Other

Achievements

Interested in Reading and Travelling

Article on “The Economics of Technical Debt” published in PGPEx business review

Finalists in Sammantran IIM Bangalore Case study competition(2014)

Consistently rated in top 5% of the project of 400+ associates and rated with A-band

Shortlisted among top 20 Tata Administrative Services (2013) candidates for final round

Awards &

Certifications Coursera certification in R programming, Business strategy and Marketing

Oracle certified expert in SQL, Sun certified in Java

Diploma in Business analysis with specialization in retail domain provided by TCS

endorsed by IIBA

Awarded Star of the Month award, On the Spot award, Rising Star of the month award and

best team award in TCS