Gemcaps Healthcare RCM Platform
Gemcaps is an advanced healthcare Revenue Cycle Management (RCM) platform designed to streamline medical billing, coding, and patient services. As a Technical Lead, I led a team of 3 developers in building a robust, scalable system that handles complex healthcare data processing and real-time analytics.
Core Features
Medical Coding Automation
- Real-time ICD-10 and CPT code validation
- Machine learning-powered code suggestions
- Automated code review with 98% accuracy
- Custom rule engine for coding compliance
Billing Management
- Automated claim generation and submission
- Real-time payment processing
- Customizable billing rules and fee schedules
- Multi-payer integration support
Patient Services Portal
- Insurance eligibility verification
- Appointment scheduling and automated reminders
- Secure document exchange and digital forms
- Patient payment processing and financial counseling
Data Processing & Analytics
- Real-time data processing pipeline for claims and payments
- Advanced analytics dashboard for revenue insights
- Automated reporting and KPI tracking
- Predictive analytics for revenue forecasting
Technical Architecture
Data Pipeline Design
- Designed and implemented ETL pipelines using AWS Glue
- Real-time data processing with AWS Lambda functions
- Batch processing for large datasets using AWS ECS
- Data validation and quality checks at each pipeline stage
Database Architecture
- Designed normalized database schema for healthcare data
- Implemented efficient indexing strategies for query optimization
- Set up database replication and backup systems
- Optimized query performance for real-time analytics
System Architecture
- Microservices architecture for scalable deployment
- Containerized services using Docker and AWS ECS
- Load balancing and auto-scaling configuration
- High availability setup with multi-region deployment
Technical Stack
-
Frontend:
- Next.js 14 with TypeScript
- shadcn/ui for component library
- React Query for state management
- Tailwind CSS for styling
-
Backend:
- Node.js with TypeScript
- PostgreSQL with Drizzle ORM
- Redis for caching
- RESTful API architecture
-
Infrastructure:
- AWS ECS for container orchestration
- AWS Lambda for serverless functions
- AWS SNS/SES for notifications
- AWS S3 for document storage
- AWS Glue for workflow management
Leadership & Development
- Led a team of 3 developers in implementing core features
- Established coding standards and best practices
- Conducted code reviews and mentored team members
- Managed sprint planning and technical debt reduction
Key Benefits
- Automation: Streamlines workflows to reduce errors and improve efficiency
- Security: HIPAA-compliant with encryption and multi-factor authentication
- Performance: Optimized with server-side rendering, Redis caching, and CDN
- Scalability: Handles growing data volumes with efficient processing pipelines
Development Practices
- CI/CD: Automated pipelines using GitHub Actions
- Testing: Comprehensive test coverage with Jest and Cypress
- Documentation: Detailed API docs, system architecture, and user guides
- Monitoring: Real-time system monitoring and alerting
Future Enhancements
- AI-powered coding assistance
- Advanced patient engagement features
- Mobile app development
- Enhanced analytics and reporting capabilities