100+ Carelon Global Solutions Interview Questions and Answers

Different types of databases include relational, NoSQL, graph, and time-series databases.

• Relational databases: store data in tables with rows and columns (e.g. MySQL, PostgreSQL)

• NoSQL databases: flexible, schema-less databases (e.g. MongoDB, Cassandra)

• Graph databases: store data in nodes and edges to represent relationships (e.g. Neo4j)

• Time-series databases: optimized for storing and querying time-stamped data (e.g. InfluxDB)

BRD stands for Business Requirements Document and Use Case is a technique used to identify, clarify and organize system requirements.

• BRD is a formal document that outlines the business requirements of a project

• It includes the project scope, objectives, stakeholders, functional and non-functional requirements

• Use Case is a technique used to identify, clarify and organize system requirements

• It involves creating scenarios of how users interact with the system to achieve specific ...read more

Ridge and Lasso are regularization techniques in regression to prevent overfitting by adding penalty terms to the cost function.

• Ridge regression adds a penalty term equivalent to the square of the magnitude of coefficients (L2 regularization).

• Lasso regression adds a penalty term equivalent to the absolute value of the magnitude of coefficients (L1 regularization).

• Ridge regression tends to shrink the coefficients towards zero but does not set them exactly to zero.

• Lasso regress...read more

Reflections in C# allow for runtime inspection and modification of types, objects, and assemblies.

• Reflections can be used to dynamically load assemblies and types at runtime.

• Reflections can be used to inspect and modify properties, fields, and methods of objects.

• Reflections can be used to create new instances of types and invoke their methods.

• Reflections can be used to generate code dynamically using System.Reflection.Emit namespace.

• Reflections can be slow and should be used ...read more

Agile is iterative and flexible, while waterfall is sequential and rigid.

• Agile involves continuous feedback and adaptation, while waterfall follows a linear approach.

• Agile allows for changes throughout the project, while waterfall requires detailed planning upfront.

• Agile promotes collaboration and communication among team members, while waterfall has distinct phases with limited interaction.

• Agile is better suited for projects with evolving requirements, while waterfall is ide...read more

Object-oriented programming concepts focus on creating objects that interact with each other to solve complex problems.

• Encapsulation: Bundling data and methods that operate on the data into a single unit (object)

• Inheritance: Allowing a new class to inherit properties and behavior from an existing class

• Polymorphism: Objects of different classes can be treated as objects of a common superclass

• Abstraction: Hiding the complex implementation details and showing only the necessary ...read more

Root cause can be found through a systematic approach of identifying and analyzing the problem.

• Gather data and information about the problem

• Identify possible causes through brainstorming or fishbone diagram

• Analyze the data to determine the most likely cause

• Verify the cause through testing or experiments

• Implement corrective actions to address the root cause

Data structures are ways to organize and store data in a computer system.

• Arrays: a collection of elements stored in contiguous memory locations

• Linked Lists: a sequence of elements where each element points to the next one

• Stacks: a Last In First Out (LIFO) data structure

• Queues: a First In First Out (FIFO) data structure

• Trees: hierarchical data structures with a root node and child nodes

• Graphs: a collection of nodes connected by edges

OOPS concepts in Java refer to the principles of Object-Oriented Programming such as Inheritance, Encapsulation, Polymorphism, and Abstraction.

• Inheritance: Allows a class to inherit properties and behavior from another class.

• Encapsulation: Bundling data and methods that operate on the data into a single unit.

• Polymorphism: Ability of a method to do different things based on the object it is acting upon.

• Abstraction: Hiding the implementation details and showing only the necessa...read more

MVC is a software architecture pattern that separates an application into three interconnected components: Model, View, and Controller.

• Model represents the data and business logic of the application

• View is responsible for rendering the user interface

• Controller handles user input and updates the model and view accordingly

• MVC promotes separation of concerns and modularity

• MVC is widely used in web development frameworks like Ruby on Rails and ASP.NET

COBOL is a programming language used for business applications. JCL is a job control language used to execute mainframe jobs.

• COBOL stands for Common Business Oriented Language

• COBOL is used for developing business applications such as banking, insurance, and finance

• JCL is used to specify the sequence of jobs to be executed on a mainframe computer

• JCL is used to allocate resources such as memory and disk space for the jobs

• JCL statements are executed in a batch mode

CNAME stands for Canonical Name and is used in DNS to alias one domain name to another.

• CNAME records are used to point one domain name to another domain name.

• They are often used for creating subdomains or pointing a domain to a CDN.

• CNAME records cannot be used for the root domain (apex domain).

PBM testing skills involve verifying drug formulary, claims processing, and member eligibility.

• Verify drug formulary to ensure correct medications are covered

• Test claims processing to ensure accurate billing and payment

• Validate member eligibility to ensure proper access to benefits

PI planning is a collaborative event where Agile teams align their work with the organization's goals for the upcoming Program Increment.

• PI planning is a two-day event that involves all members of the Agile team, including stakeholders and product owners.

• The goal of PI planning is to create a shared understanding of the work that needs to be done in the upcoming Program Increment.

• During PI planning, teams create a plan for the upcoming PI, including identifying dependencies a...read more

An anatomical modifier is a two-character code used in medical coding to indicate a specific location or aspect of a procedure or service.

• Anatomical modifiers are used to provide additional information about a procedure or service.

• They are typically used in surgical procedures to indicate the specific location or aspect of the procedure.

• Examples of anatomical modifiers include LT (left side), RT (right side), and F1 (first digit).

US Healthcare is a complex system that involves various stakeholders. PBM is a third-party administrator that manages prescription drug benefits for health plans.

• US Healthcare involves multiple players such as patients, providers, payers, and pharmaceutical companies

• PBM stands for Pharmacy Benefit Manager

• PBM negotiates drug prices with manufacturers, manages formularies, and processes claims for prescription drugs

• PBM also provides clinical programs such as medication therapy ...read more

PBM CLAIMS life cycle involves claim submission, adjudication, payment, and reconciliation.

• Claim submission: Member or provider submits a claim to PBM.

• Adjudication: PBM reviews the claim for eligibility and determines coverage and payment.

• Payment: PBM pays the claim amount to the provider.

• Reconciliation: PBM reconciles the claim with the plan sponsor and updates records.

Difference between dense rank and row number

• Dense rank assigns the same rank to ties, while row number assigns a unique rank to each row

• Dense rank skips ranks when there are ties, while row number does not

• Dense rank is used to calculate percentiles, while row number is used for pagination

Obstetrics package is a bundled payment system for prenatal, delivery, and postpartum care.

• It includes all services related to pregnancy, delivery, and postpartum care

• The package may include prenatal visits, ultrasounds, delivery, and postpartum check-ups

• The cost of the package is usually lower than paying for each service separately

• Insurance companies may offer obstetrics packages as part of their coverage

• Examples of obstetrics packages include Global Maternity Care Package ...read more

Abstraction is the concept of hiding complex details and showing only the essential features of an object or system.

• Abstraction allows us to focus on what an object does instead of how it does it

• It helps in reducing complexity and improving efficiency

• For example, in programming, abstract classes and interfaces are used to achieve abstraction

Polymorphism allows objects of different classes to be treated as objects of a common superclass. Abstraction hides the implementation details and only shows the necessary features of an object.

• Polymorphism enables a single interface to be used for different data types or classes. For example, a superclass Animal can have subclasses like Dog and Cat, and a method speak() can be called on any object of Animal type.

• Abstraction focuses on what an object does rather than how it d...read more

End to end operation refers to the complete process from start to finish, involving all steps and stakeholders.

• End to end operation involves all stages of a process, from initiation to completion.

• It includes all stakeholders and departments that are part of the process.

• Efficient end to end operations ensure smooth flow and timely delivery of products or services.

• Example: In a manufacturing company, end to end operation includes sourcing raw materials, production, quality cont...read more

Claims are statements made by individuals or organizations to request compensation or reimbursement for damages or losses.

• Claims are typically made to insurance companies, government agencies, or other entities responsible for providing compensation.

• They can involve various types of damages or losses, such as property damage, personal injury, or financial losses.

• Claims often require supporting documentation, such as receipts, medical records, or witness statements.

• The process...read more

Polymorphism is the ability of a function or method to behave differently based on the object it is acting upon.

• Polymorphism allows objects of different classes to be treated as objects of a common superclass.

• There are two types of polymorphism: compile-time (method overloading) and runtime (method overriding).

• Example: Inheritance allows a child class to override a method of its parent class, providing different functionality.

Insurance is a financial protection against potential losses or damages.

• Insurance is a contract between an individual or organization and an insurance company.

• The individual or organization pays a premium in exchange for coverage against specific risks.

• In case of a covered loss or damage, the insurance company compensates the policyholder.

• Types of insurance include health, auto, home, life, and business insurance.

• Insurance helps individuals and organizations manage financial ...read more

Real world example of OOP is modeling a car as an object with properties and methods.

• Objects represent real-world entities

• Classes define the blueprint for objects

• Encapsulation hides internal implementation details

• Inheritance allows for code reuse

• Polymorphism enables objects to take on multiple forms

Use SQL query with ORDER BY and LIMIT to find the 2nd highest salary in a table.

• Use ORDER BY clause to sort the salaries in descending order

• Use LIMIT 1,1 to get the second highest salary

• Example: SELECT salary FROM employees ORDER BY salary DESC LIMIT 1,1

Lookup is used in ETL processes to search for a specific value in a dataset and retrieve related information.

• Lookup is used to search for a specific value in a dataset

• It retrieves related information based on the search criteria

• Lookup can be used to join data from different sources based on a common key

There are three types of lookup transformations: Connected, Unconnected, and Cached.

• Connected lookup transformation is used to look up data from a relational table or view.

• Unconnected lookup transformation is used to look up data from a flat file or external source.

• Cached lookup transformation stores the lookup data in memory for faster access.

The question seems to be incomplete or unclear, possibly a typo.

• It appears that the question is incomplete or contains a typo.

• It is unclear what 'zeta olays a' refers to or what the interviewer is asking.

• Consider asking for clarification or providing a response based on the context of the interview.

Co-insurance is the percentage of costs of a covered healthcare service that you pay after you've paid your deductible.

• Co-insurance is the percentage of costs of a covered healthcare service that you pay after you've paid your deductible.

• It is the portion of the medical expenses that the insured individual is responsible for paying.

• For example, if your co-insurance is 20%, you would pay 20% of the covered medical expenses while the insurance company pays the remaining 80%.

Healthcare functionality refers to the specific features and capabilities of a software system that cater to the needs of healthcare industry.

• Ensure compliance with HIPAA regulations

• Implement secure data encryption

• Integrate with electronic health records (EHR) systems

• Support telemedicine capabilities

• Provide tools for medical billing and insurance claims processing

Business analysts can be categorized into various types based on their roles and focus areas within an organization.

• 1. Strategic Business Analyst: Focuses on long-term goals and strategies, often working with senior management.

• 2. Data Analyst: Specializes in analyzing data to inform business decisions, using tools like SQL and Excel.

• 3. IT Business Analyst: Bridges the gap between IT and business, ensuring technology solutions meet business needs.

• 4. Process Analyst: Examines a...read more

Job abends are abnormal ends to a job or program due to errors or exceptions.

• Job abends can occur due to syntax errors in JCL or COBOL programs.

• Data errors or invalid input can also cause job abends.

• Resource constraints like lack of memory or disk space can lead to job abends.

• Unexpected system failures or interruptions can result in job abends.

• Examples include S0C7 (Data exception), S0C4 (Protection exception), and S522 (Insufficient space).

Polygons are closed shapes with straight sides that are made up of multiple line segments.

• Polygons have at least three sides

• All interior angles of a polygon add up to 180 degrees

• Examples of polygons include triangles, squares, pentagons, etc.

AutoCAD is a computer-aided design software used for creating 2D and 3D drawings and models.

• AutoCAD is a software application developed by Autodesk.

• It is commonly used by architects, engineers, and designers for creating precise drawings and models.

• AutoCAD allows users to create, edit, and annotate drawings in 2D and 3D.

• It includes tools for drafting, modeling, and visualization.

• AutoCAD files are saved in .dwg format.

The eraser tool in AutoCAD is used to remove unwanted lines or objects from the drawing.

• The eraser tool is typically located in the toolbar or can be accessed by typing 'ERASE' in the command line.

• To use the eraser tool, simply click on the object you want to erase or select multiple objects to erase at once.

• You can also use the 'Undo' command (Ctrl + Z) to remove the last action taken in case you make a mistake.

• The eraser tool is essential for cleaning up drawings and making...read more

Analytical functions in SQL are used to perform calculations on a set of rows and return a single result for each row.

• Analytical functions are used to calculate running totals, moving averages, and rank functions.

• They are used with the OVER() clause to define the window of rows to be used in the calculation.

• Examples of analytical functions include ROW_NUMBER(), RANK(), DENSE_RANK(), LAG(), LEAD(), SUM(), AVG(), MAX(), and MIN().

Co-pay is a fixed amount that an insured person pays for covered services, typically due at the time of service.

• Co-pay is a set fee that the insured individual must pay for certain medical services or prescriptions.

• It is a form of cost-sharing between the insurance company and the insured.

• Co-pays can vary depending on the type of service or medication.

• For example, a doctor's office visit may have a $20 co-pay, while a prescription may have a $10 co-pay.

Co-insurance is a cost-sharing arrangement between the insurance company and the insured individual, where both parties pay a percentage of the covered expenses.

• Co-insurance is a percentage of the total cost of a covered healthcare service that the insured individual is required to pay.

• It is typically specified in the insurance policy and is in addition to any co-payments or deductibles.

• For example, if the insurance policy has a 20% co-insurance requirement and the total cost...read more