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Business Analyst Resume

Philadelphia, PA

SUMMARY:

  • Imaginative IT Professional with meaningful experience as a Business Analyst and proven skills in Business Requirement Gathering, Business Process Workflow, and Business Process Modeling.
  • Transformational leader with the ability to develop valuable professional relationships through a commitment to trust and transparency; inspired by big challenges with a passion for helping others succeed through shared learning and teamwork.
  • Highly analytical thinker with proven ability and knowledge within the Health Care Industry, Claims Management processes, Medicaid, and Medicare Services;
  • Exceptional analyst with proficiency in all phases of Requirement Management including gathering, analyzing, detailing, and tracking requirements.
  • Ambitious, high - energy self-starter with demonstrated ability in 4010 and 5010 HIPAA implementation guides related to Claim Testing and Medical Billing and the capacity to excel within fast-paced, deadline-driven situations.
  • Hardworking and resilient professional with inspiring leadership ability, excellent communication skills, and a proven ability to analyze sophisticated problems, identify risks, and develop effective solutions to improve productivity, reduce COs, and track progress through all SDLC phases.

TECHNICAL SKILLS:

Microsoft / Technologies: Advanced Excel, Word, Outlook, SharePoint, SSMS, Service Now

Operating Systems: Windows 2000/7 Enterprise/XP, MacOSX

Languages / Standards: SQL, HIPPA 4010/5010, ICD9/10

Methodologies: Agile

PROFESSIONAL EXPERIENCE:

Confidential, Philadelphia, PA

Business Analyst

Responsibilities:

  • Employed sharp power of observation and analysis in execution of weekly, bi-weekly, and monthly reports; created ad-hoc reports.
  • Exhibited superior attention to detail and exceptional work ethic by logging all CSV files, outbound 837 files, and 999/277CA response files.
  • Leveraged experience and skill to automate submission of transactions in partnership with IT Department; process imports adjudicated claims into revenue reconciliation manager and Finalized them to enable submission to reporting authority.
  • Exercised detailed analysis and judgment by updating BRD to reflect latest business requirements.
  • Provided insightful vision and guidance for development of monthly Corrective Action Plans designed to inform client of current errors and rejections.
  • Created environment for durable success by ensuring proper development and deployment while assisting QA to test requirements.
  • Analyzed data relating to claims, members, and providers through use of existing queries and reports.
  • Ensured all claims were successfully made into outbound encounters for submission by checking recon report daily.

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