Healthcare Revenue Cycle ♾️

SQL-based Healthcare Revenue Cycle & Business Intelligence analysis using star schema database design. Includes financial performance, collection rate analysis, CPT utilization, payer reimbursement, and demographic reporting.

AI-powered medical coding, CDI automation, and revenue cycle optimization. Anthropic AI Hackathon submission.

CodeSilver is an ambient AI prototype that translates clinical language into operational healthcare insights using synthetic data and public CMS rules, helping reduce documentation gaps without interrupting clinicians.

Healthcare Data Analytics Portfolio | Revenue Cycle | SQL | Power BI | C++ | KPI Reporting | Denials & Authorizations

🩺 Translate clinical discussions into real-time hospital operations data to reduce errors and improve workflow efficiency.

X12 EDI Claims Pipeline — 270/271 eligibility, 837P professional claims, 835 remittance advice with revenue cycle analytics. Built with Synthea FHIR R4 synthetic data.

AI-powered provider credentialing monitor for mental healthcare platforms: tracks expiration dates, generates urgency-calibrated outreach, verifies renewal submissions, and escalates to humans only when judgment is required.

End-to-end healthcare revenue cycle analytics platform: synthetic claims data, SQL warehouse, data-quality engine, denial-risk ML model, statistical analysis, and dashboards. All data is synthetic.

835/837 → payor mix, denial root cause, contracted-rate variance, AR aging cohort. Agentic AI for healthcare RCM.

AI agent that classifies denied insurance claims, retrieves CMS/payer policies via RAG, and generates policy-cited appeal letters

Checks medical claims for NCCI bundling and unit-cap edits before submitting. Reasons for each flag are provided.

AI-powered insurance claims pipeline monitor for mental healthcare platforms: tracks outstanding claims, generates escalating payor outreach, classifies denial codes, and routes each claim to the correct resolution path automatically.

Curated resources for healthcare payer risk, denial prevention, and revenue cycle management

Revenue cycle analytics platform for denial prevention, appeal prioritization, payer friction, underpayment discovery, work queues, ML scoring, and GitHub Pages deployment.

R1 RCM is a major US corporation and Fortune 1000 company. The R1 RCM API provides programmatic access to its platform services, data, and integrations for enterprise customers and partners.

AI remittance-adjudication engine for dental revenue cycle: grounded, cited RAG that interprets EOBs, reconciles to the cent, and fails closed.

Interactive SNF revenue cycle billing demo — PDPM rate build-up, Medicare benefit-period tracking, and claim/denial management. Portfolio piece by North Bridge Solutions. Illustrative data only.

Availity is a healthcare information network and clearinghouse providing REST APIs for real-time HIPAA EDI transactions. The platform processes over 11 billion annual healthcare transactions connecting providers, health plans, and vendors nationwide.