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lp07/README.md

Lisa Patel — Healthcare Data Engineer

I build data infrastructure for healthcare revenue cycle operations. EDI 837/835 pipelines, denial management systems, and remittance reconciliation — focused on the intersection of healthcare domain knowledge and data engineering.

Stack: Python · SQL · Snowflake · Azure Data Factory · Power BI · dbt · AWS · REST APIs

Projects

835/837 Remittance Reconciliation Pipeline

Two-tier matching engine parsing raw EDI files, classifying payments into 6 categories, surfacing $430K+ revenue at risk across 1,200+ claims.

Healthcare Claims Data Quality Intelligence Platform

Pre-submission EDI 837 validation pipeline enforcing payer-specific rules across BCBS, Aetna, Cigna, and Humana.

Intelligent Claim Routing Engine

7-factor denial risk scoring engine routing 1,200+ claims across 5 operational queues in under 0.2 seconds. 73% auto-processed without human touch.

📍 Dallas, TX

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  1. intelligent-claim-routing-engine intelligent-claim-routing-engine Public

    Multi-factor denial risk scoring and queue assignment engine for healthcare RCM operations. Routes 1,200+ claims across 5 operational queues using a 7-factor weighted model.

    Python

  2. Healthcare-Claims-Data-Quality-Intelligent-Platform Healthcare-Claims-Data-Quality-Intelligent-Platform Public

    Pre-submission EDI 837 validation pipeline enforcing payer-specific rules across BCBS, Aetna, Cigna, and Humana. Identifies $430K+ revenue at risk across 1,200+ claims per run.

    Python

  3. 835-837-Remittance-Reconciliation-Pipeline 835-837-Remittance-Reconciliation-Pipeline Public

    Two-tier Python matching engine parsing raw 837/835 EDI files, auto-classifying payments into 6 categories and surfacing $430K+ revenue at risk across 1,200+ claims.

    Python