Healthcare Claims Processing System (CPHA-Compliant)
In plain terms: this project replaced the way health-insurance claims moved between organizations with a secure, high-volume system that had to meet strict regulatory rules, because even a small error in sensitive patient data wasn't acceptable.
The Challenge
A regulated healthcare organization needed a CPHA-compliant claims routing system to process live, sensitive PHI data at scale, connecting pharmacy systems to adjudicators over a secure network, with zero tolerance for compliance gaps or data integrity issues.
My Role
Project Coordinator, managing BA and QA delivery from requirements through production go-live.
What I Did
- Contributed to stakeholder workshops with 30+ participants across business, IT, and vendor teams
- Co-authored the Business Requirements Document with close to 100 requirements, translating regulatory workflows into functional specifications
- Designed and executed 110+ test cases in Azure DevOps
- Maintained the RAID log during early project phases
- Collaborated daily across development, infrastructure, security, and testing teams
The Outcome
97%+ test pass rate across all requirements. The system launched on schedule and is live in a regulated production environment, with zero compliance issues flagged at launch. (Some details limited due to NDA.)
I had the pleasure of working closely with Suhana, where she supported a complex initiative involving multiple teams and external stakeholders. Suhana consistently brought a positive attitude, enthusiasm, and a strong willingness to take on whatever was needed. She is dependable, collaborative, and approaches her work with genuine commitment and professionalism. I particularly appreciated her responsiveness and her ability to support the team across a wide range of activities in a fast-moving program environment.