Business Analyst I Resume Woodland Hills, CA - Hire IT People

TECHNICAL SKILLS:

Proficient with Microsoft Office (Word, Excel, Power Point, Outlook) Windows XP, Vista,7, 8 and 10, Track It System, SQL - System Language (Basic),Telnet (CMS Processor) Object-Oriented Programming (Basis).
ISG (Individual and Small Group Membership system) or Mainframe, HICS (Health Insurance Casework System), WEM (Web Insure Exchange Manager), Pre-Audit Files and HICS CMS Case Investigation or Database, CRM, SharePoint, and Softheon.

PROFESSIONAL EXPERIENCE:

Confidential

Business Analyst I

Coordinate the overall resolution process by evaluating and resolving in compliance with federal, state, and organizational grievance procedure guidelines.
Able to effectively search for and type information on the computer, navigate through multiple windows and screens quickly, and inputting information accurately
Provide an accurate and thorough explanation of health plan benefits, claims processes, eligibility, and enrollment.
Resolve simple to complex problems for members.
Responsible for responding to current or potential members in a timely, professional, and courteous manner
Associates are expected to meet established performance goals in the areas of call quality, customer satisfaction, first call resolution, adherence, and attendance.

Confidential, Woodland Hills, CA

Customer Care Representative

Respond to customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims.
Analyze problems and provide information/solutions. Operate a PC/image station to obtain and extract information; documents information, activities and changes in the database.
Develop and maintain positive customer relations and coordinate with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
Research and analyze data to address operational challenges and customer service issues.
Provide external and internal customers with requested information. Under immediate supervision, receive and place follow-up telephone calls / e-mails to answer customer questions that are routine in nature.
Use computerized systems for tracking, information gathering and troubleshooting.
Require limited knowledge of company services, products, insurance benefits, provider contracts and claims. Seek, understand and respond to the needs and expectations of internal and external customers.

Confidential, Santa Monica, CA

Customer Service Representative

Worked with customer service manager to ensure proper customer service is being delivered.
Ensures and provides quality service to both internal and external customers.
Solid planning skills, excellent follow-up and ability to multi-task.
Ability to solve problems and carry out responsibilities under general supervision.
Strong customer service and results orientation with high degree of confidentiality.
Excellent written and verbal communication skills.

Confidential, Brockton, MA

CBFS/Mental Health Worker

Provided a variety of peer support, advocacy, and other recovery services to clients transitioning to community living in a mental health facility.
Transported consumers to and from day programs, medical appointments and other activities as required.
Assisted clients in developing independent living skills in activities such as housekeeping, cooking, shopping, budgeting, using public transportation, and attending to personal grooming and hygiene, etc. through demonstration and coaching.
Facilitated clients' participation with multi-disciplinary teams by assisting in formulating services goals and plans for achieving such goals.
Assisted clients with obtaining and completing appropriate application forms for various benefits and services.