Chakravarti Kavalapure

Chakravarti Kavalapure

Work History

Work History
May 2010 - Present

Product Designer (Business Analyst)

Allscripts Solutions
  • Writing requirement specifications and functional specifications, participation in requirement session with clients.
  • Requirements are discussed with users and gathered so that they can provide an understanding of the problem or opportunity before trying to propose a solution.
  •  Interviews, surveys and analysis of historical data.
  • Organize brainstorming, facts-finding and structured walkthrough sessions.
  •  Identify source of requirements and develop priority matrix. 
  • Provide the required domain and functional knowledge to the Test team.
  •  Test the application and Interact and liaise with the technology team to resolve functional & technical queries.
  •  Analyze Operational Procedures & Processes to identify areas for automation or improved workflow.
  •  Finding out gaps in existing process, arranging training plans for new process development and  implementation.
  • Provide assistance to the entire team to have an understanding of the project- respond to questions, obtain and provide clarification for designs.
  • Serve as a conduit for effective communication between team members in India and team members in North America.
  • Triage Defects.
  • Participate in the design and have a full understanding of all assigned projects and the full Revenue Cycle Management.
  • Preparation of functional test scenarios including end to end scenarios.
  • Document the potential test case which will be used during the test phase of project.
  • Provide inputs to develop the application which would contain the data of the clients.
  • Follow Scrum and Pie concepts.
  • Conducting User Acceptance Testing (UAT) and verifying performance, reliability and fault tolerance issues.
  • Performing GAP analysis and SWOT analysis.
  • Responsible to conduct DAILY SCRUM MEETING and lead the meeting as a SCRUM MASTER.                                           
Aug 2009 - May 2010

Subject Matter Experct

EXL Services
  • Joined as SME for Adjudication process (Workers Compensation)
  • Part of transition team in project migration.
  • Attended client training and discussions.
  • Conduct team meetings, team huddles and process update.
  • Conducted training for new batches
  • Sharing and updating team about changes in guidelines
  • Assigning work and reporting back to client with status
  • Scrutiny of Claims at the Initial stage.
  • Ensure that the Payment is released for the appropriate claim as per contract.
  • Adjudication of US Workers Compensation claims as per US WCB.
  • Auditing high dollar claims before final payment
  • Ample experience  and apply plan concepts to include:- Deductible, Coinsurance, Copay, Out-of-Pocket Maximums, Coordination of Benefits (COB), carve-out and alternate benefits inside limits & exclusions State variations and Explanation of Benefit (EOB)
Aug 2006 - Aug 2009

Senior Analyst

Hinduja Global Solutions
  • Processing US Health Insurance Claims under the guidelines provided by client.
  • Scrutiny of Claims at the Initial stage.
  • Calculating payable benefits
  • Maintaining all quality parameters.
  • Explaining claim denials, payments, and contract provisions to marketers, clients and healthcare providers through correspondence.
  • Auditing the Claims processed by other examiners
  • Requesting additional information needed to determine benefits
  • New assignments and projects with an open, cooperative, positive and team-oriented attitude
  • Checking subscribers benefit covered under the insurance plan, also verifying the Authorization using Sophisticated Embedded Software Platform
  • Attend Client calls from US regarding routine updates, query resolutions with Quality Auditors.
  • Sub Group Head - handling a team of 9 members
  • Conduct team meetings, team huddles and process update
  • Responsible for team production and quality
  • Reporting the status of inventory to stateside
  • Training to new joinee and conducting FIT.



Patient Financial Manager, Sunrise Financial Manager

MS Visio



MS project

MS Office


Aug 2004 - Aug 2006


Bangalore University
Jun 2000 - Jun 2003


Karnataka University Dharwad


To take a challenging role on business operations as Business Analyst and give a efficient and effective solution that would help the organization to achieve the best solution in business which would increase its productivity in market.


To harness a strong track record of building volumes and growing profitability in an efficient, dynamic & a professional organization which recognizes and rewards top performers to utilize Technical, Interpersonal & Professional talents to maximize the efficiency and develop the company’s growth.

Achievements and Recognition

Recognized for Outstanding Performance in several Months

Received Top Gun Awards

For maintaining 100% quality and achieving targets received numerous client appreciations.

Synopsis of Strength

Strong Analytical skills - Ability to analyze requirements from client and developer perspective, ability to keep the larger picture in mind.

Able team player with good communication and interpersonal skills.

Flexible and quickly adapt to new business domains.

Willingness to learn and adapt to new challenges.


Healthcare IT professional with an enterprise wide 4.5+ years of experience in the Healthcare industry from both Payer and Provider’s part. A rare talent who could be a solution provider for mundane operational issues in the Revenue Cycle Management vertical with profound depth of the domain coupled with IT tools. Have very good exposure towards all walks of US healthcare - RCM with specialization on handling projects on EDI comprising legacy formats of NSF; indigenous standards till 5010 HIPAA mandated X12N standards. Knowledge of medical terminology, ICD-10, CPT, HCPCS, Revenue codes, CMS 1500 and UB-04 Have sound understanding towards most of the physician and hospital practice systems. Have been a compliance officer for a huge healthcare services organization and have been instrumental in devising and practicing effective methodologies of implementing HIPAA standards. Payers & Health plans – Medicare, Medicaid, BCBS, Commercial, WComp, Medigap, etc. Claim Adjudication (Re-pricing of Claims, Pre-Adjudication Edits) Healthcare products – PPO, HMO and POS             

Personal Information

Marital Status          : Single

Languages Known  : English, Hindi, and Kannada.

DOB                        : 03/07/1982

Current location      : Pune

Passport                  : Yes

Ready to relocate    : Yes