Fardin Quazi - BPaaS Model for Healthcare - Medicare & Medicaid

The BPaaS (Business Process as a Service) in Healthcare by Cognizant is a scalable, efficient, and compliant cloud platform model tailored for Medicare and Medicaid. It standardizes processes across multiple states and clients, offering flexibility, cost savings, and faster time-to-market for new products. By integrating advanced automation technologies like RPA and IPA, the model enhances process efficiency, reduces errors, and improves service delivery, setting a new industry benchmark.

Overall Performance across multiple clients:

• 25% reduction in plan administration costs.

• 600% increase in claims processing speed, saving millions annually, with 99%+ accuracy.

• RPA Integration: Saved 17,000 hours by eliminating manual input errors.

• Regulatory Compliance: EUM acceptance rates increased from 83% to 95%.

• Customer Satisfaction: 15% reduction in call volumes through modern IVR and automated HIPAA validation.

• Revenue Impact: 30% reduction in claim denials, adding millions of dollars in revenue.



My Contributions:

With 19+ years of experience in Digital Transformation within US Healthcare (Payer-Provider), Govt. LoB (Medicare-Medicaid), I was appointed Lead Project Manager for multiple tracks & clients.

• I led the conceptualization, development, and implementation of the BPaaS Model, ensuring it became the industry standard for efficiency and compliance.

• Oversaw the design and implementation of workflows across key operational tracks - Provider Data Management, Claims Auto Adjudication and Management, Ancillary services, Mailroom, Front Office, Fulfillment, Contact Center Services, Utilization Management, and Intake operations, establishing KPIs, BRDs, and TDDs, ensuring cohesive service delivery across all tracks.

• As Track Lead for a leading Texas-based Health Plan, created a savings roadmap of $900 million over 7 years, deployed RPA, saving 17000 hours and eliminating 100% input errors in medical appointments. Achieved 15x reduction in claims inventory, and 4x reduction in average days in-house for pending claims.

• As Change Manager, implemented scores of high dollar value Change Requests in five months, maintaining the platform’s agility.

• Managed the processing of thousands of pending claims worth millions in 2.5 months, demonstrating the model’s effectiveness.

• As Vendor Manager, ensured adherence to CMS guidelines, managed third-party vendors, developed SLAs, and created a Scenario-based Transition playbook