Executive Summary
The Velocity Benefits & Claims Platform is an enterprise-scale software system powering healthcare insurance administration, policy management, and claims adjudication for major US healthcare providers.
As a Senior Consultant, I architected core backend services, validation workflows, and financial batch processing pipelines to support high-throughput, mission-critical operations under strict regulatory SLAs.
Key Responsibilities & Contributions
1. Claims Adjudication & Rules Engine
- Designed and implemented auto-adjudication decision workflows for Dental, Health, and HCSA (Health Care Spending Account) claims.
- Integrated Drools business rules engines to evaluate complex benefit plans, deductibles, co-pays, and provider network coverage in real-time.
2. High-Throughput Microservices & REST APIs
- Developed scalable Spring Boot REST APIs handling Member Balance inquiries, Claims Submission, Group Enrollment, and Plan Administration.
- Engineered asynchronous messaging queues and scheduled batch jobs for payments, financial disbursement, and automated Explanation of Benefits (EOB) document generation.
3. Production Support & JVM Optimization
- Led root-cause analysis (RCA) for critical Level-3 production incidents, maintaining a >99.9% resolution rate within strict SLA windows.
- Resolved memory leaks and JVM
OutOfMemoryErrorconditions through heap dump analysis, GC tuning, and query execution plan optimization in PostgreSQL/Oracle.
Technical Stack
- Languages & Frameworks: Java (11/17), Spring Boot, Spring Batch, Hibernate/JPA, Drools
- Databases & Messaging: PostgreSQL, Oracle DB, Apache Kafka
- Infrastructure & Tools: Docker, Jenkins CI/CD, Git, Linux, JProfiler, Postman