Business Consultant Analyst Resume

SUMMARY:

Motivated and Innovative Health Care Management Professional, with a background in medical claims adjudication, revenue cycle, user acceptance testing, Sales and Marketing. Skilled in building cohesive, productive teams while fostering open communication to drive process improvements.

CAPABILITIES INCLUDE:

Managed Care
Medicare Guidelines
Authorizations & Tapestry UM
Test Plan & Execution
Benefits
Reporting & Analytics
Quality Assurance
Revenue Cycle
Strategic Planning
Requirement Gathering & Documentation
Collaboration & Innovation
Epic Core Certified & Epic AP Proficient, NVT 2016

COMPUTER SKILLS:

Microsoft Office
Webstrat
Quality Center
Ableton
Final Cut X
Encoder Pro
FormWorks
SharePoint
Quick Books
Epic Certified Tapestry CORE
Conflict
KP Academy Health Connect PB
Epic Proficient Tapestry AP
Leading Effective Teams
Facilitative Leadership
Epic Benefits Engine
7 Habits of Highly Effective People

PROFESSIONAL EXPERIENCE:

Confidential

Business Consultant Analyst

Responsibilities:

Subject Matter Expert (SME) - Authorizations / Tapestry UM
Managed and trained testing team members SCAL
Test Planning, Test Execution & Test Closure - SCAL
Developed, wrote and executed use cases/ test cases
AP Claims Processing - End to End
Revenue Cycle
External Claims and Contracts
UM Management Referrals/Authorizations
Elicit, Capture & Document Business Requirements for both current and future state operational specifications and process, which involved leading and participating in cross-functional task forces
Successfully navigated the necessary tools and systems needed to perform testing and defect management taking into account and ensuring the most critical, significant requirements for testing are addressed as early as possible ensuring that any dependencies (sequence, data, etc.) are accounted for in the testing
Developed relationships with Upstream and Downstream Business Stakeholders and Partners to solve complex problems in creative and effective ways
Participated in Root Cause analysis sessions in partnership with operations
Managed multiple priorities and deliverables concurrently. Successfully met each milestone timely and consistently delivered as promised with integrity to meet program goals.
Analyzed defect data for trends, Defect resolution and process improvement processes through various management reports.
Provided on-going status reporting at all levels. Reporting and Analytics for trends in testing, defects that would impact upstream and downstream testing and dependencies.

Confidential, Alta Loma, CA

Bookkeeping/Account Manager

Responsibilities:

Member retention analytics identifying trends around consumption and analyzing marketing tests and activities to prove effectiveness and ROI.
Sales and Service - Developed, Implemented and Managed the advertising strategy to bring in new local customers. Personally took part in some of the larger builds, and would regularly assist in day to day calls if needed. Produces regularly scheduled reports around campaign performance and marketing analysis
Account management - Managed Account receivables and Account payables, was personally responsible for collecting any past due payments as well.

Confidential, Rancho Cucamonga, CA

Supervisor/ Key Holder

Responsibilities:

Managed the sales floor, General employee,
Store to store transfers/transfer-outs, handling inventory.
Promoting new merchandise and sales for the current events, merchandizing new and old Jerseys & other apparel for maximum sales possibility

Confidential, Ontario, CA

Co-Manger/ Coordinator

Responsibilities:

Hiring and General employee
Set schedules, sells goals, running the sales floor charting store conversion and plan goals.
Store to store transfers/transfer-outs, handling inventory for 4 stores cross checking discrepancies.
Promoted new shoes and sales for the current events, merchandizing new and old shoes for maximum sales possibility, responsible for new store openings and closing down non profitable stores and transferring out all unused merchandise.

Confidential, West Covina, CA

2nd Manger/ Floor Supervisor

Responsibilities:

Set and maintained sales goals, managing associates on the sales floor making sure they are friendly and informative,
Handled End of Day deposits and counting out registers,
Receiving and sending out shipment

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