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Business Analyst Resume

San Antonio, TX

OBJECTIVE

To obtain a professional career in the Healthcare Industry

Statement of Purpose

I possess a solid background in the Healthcare Industry. I am seeking a position with a growth-oriented, forward thinking, progressive company which will utilize my skills, abilities and knowledge to the fullest extent.

PROFESSIONAL EXPERIENCE

7/10 to presentConfidential, San Antonio, Tx.
Purchasing Agent

  • Performs various basic and advanced duties essential to the purchase of services, standard and special supplies. Prepares bids and purchase orders incident to supplies and equipment and manages the perpetual stock records.
  • Maintains storeroom stock levels within prescribed limits and ensures accuracy and proficiency in compiling, computing, coordinating, verifying, recording and routing data. Performs duties promptly and efficiently and compiles with Health System and departmental policies. Maintains good quest and working relations

12/07 to 7/10Confidential, San Antonio, Tx.
Data Analyst

  • Responsible for inputting contract and purchasing information in the automated materials management system. Prioritize and plan job functions; ability to manage projects and multi-task; and ability to professionally deal with all people in a fair and equitable manner.
  • Meet productivity standards for placement of purchase orders. Reviews purchase requests for completeness and appropriate approval authority in accordance with the purchasing policy. Proficiency in all phases of assigned duties.

4/07-11/07Confidential, San Antonio, Tx.
Configuration Analyst

  • Responsible for complex configuration and changes to current configuration. In depth understanding of the interdependencies of all major subsystems in AMISYS as well as the ramifications of changes to interrelated subsystems.
  • Work collaboratively with other areas of CFHP to determine change needed and the impact on other areas, Claims, Marketing, Network Management, Finance, UHS, and Enrollment.

5/06- 3/07Confidential. Hamden., Ct.
Configuration Auditor/Business Analyst Consultant

  • Reviewed and Analyzed business processes, current system configuration, appropriateness of the original system design, efficiency of use of the AMISYS functionality and standards established for data processing for a Medicaid Health Plan.
  • Analyzed and documented audit results for the benefit/Data Integrity, Liability/Recovery, and Medical Management sub-system configurations. Report items identified as potential inefficiencies during the analysis phase, and how the potential inefficiencies impact processing logic. Documented recommendations on how to best address the identified areas of concern.

11/99-12/05 Confidential, St. Louis, MO

Business Analyst
  • Configured benefits plans for HMO, PPO,POS,Medicare and Medicaid plans.
  • Worked on migrating membership and benefits plans to IP/CAP System
  • Created a mapping document from Amisys to Caps structure
  • Reviewed and tested data for accuracy
  • Assisted with implementation of accounts to Magellan system
  • Interacted with Magellan departments/clients to successfully implement accounts
  • Conducted and documented the effectiveness of systems solutions for the attainment of Magellan’s operational goals

06/95-11/99 Confidential, St. Louis, MO
Eligibility Analyst

  • Worked with programmers on criteria for membership configuration
  • Resolved problems that prevented a file or member loading in Amisys.
  • Provided IS support on membership issues
  • Configured correspondence letters and created templates as needed
  • Maintained AS400 denial letters in Microsoft Access
  • Ran reports on Tax ID numbers / submitted 1099 info

07/94-6/95 Confidential, St. Louis, MO
Claims Processor

  • Processed Mental Health Substance Abuse claims
  • Conducted benefits determination on HP9000 system
  • Reviewed billing codes CPT/ICD-9

09/93-07/94Confidential
Coder Coordinator

  • Abstracted information from medical charts for billing purposes, which included the sub-specialties of OB/GYN, General Surgery, and other major specialties within the Medical Center.
  • Coded surgery operative notes using ICD-9 and CPT codes for billing purposes.
  • Followed-up after record interpretation with appropriate data entry, coding and batching.

Confidential., Claims Representative, 1990-1993
Confidential, Billing Service Specialist, 1989-1990

SKILLS:

  • Lean Six Sigma Certificate
  • MS Access, Excel, Word and MS Project
  • Project Management
  • Medical Terminology
  • Amisys


EDUCATION:
BS, Business Administration (Personnel Mgmnt) /Psychology

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