Sr. Analyst Resume

SUMMARY:

Over 13 years of analytical and data reporting experience in the health insurance industry with extensive experience with executive reporting, business process improvement techniques and extracting data from multiple claim processing systems. Experience writing SQL and working with data stored in relational database systems such as SQL Server and DB2. Highly proficient in Microsoft Excel, Visio, Access

TECHNICAL SKILLS INCLUDE:

Microsoft SQL Server 2008

IBM Cognos 7.3 & 10

IBM Cognos Report Studio

IBM Analysis Studio

IBM Cognos Insight & Workspace

IBM Rational Portfolio Manager

IBM Cognos Transformer

MS Project

SAP Business Objects

Facets Claim System

MS Excel

MS Access

IBM Cognos PowerPlay

Toad for Data Analysts

Ariba Wisebuys Purchase System

PeopleSoft Financial Software

Minitab Software

PROFESSIONAL EXPERIENCE:

Sr. Analyst

Confidential

Business Analyst

Confidential

Business Analyst

Mainframe System Developer

Confidential

Responsibilities:

Staged claim & membership data using a series of Access databases and queries
Maintained data quality by staging, standardizing and de - duplicating claims data
Ensuring the claims data is reliable, accurate, and consistent across multiple data sources
Performed data defect analysis and used the information to improve processes and data quality
Able to identify, analyze and resolve gaps and work with project development teams as required
Strong business requirements gathering experience
Able to work with and assist vendors such as IBM, Connecture and HP as required
8 years of experience with Cognos data cube building & data reporting
Worked with IT to publish Cognos data cubes, reports and dashboards to the corporate website
Expertise in writing SQL code and Access queries
Reduced the number of days to request medical records from 20 days to 7 days by applying Lean Six Sigma tools such as process maps, fishbone diagrams, cause and effect diagrams and FMEA (Failure Mode and Effects Analysis).
For 3 consecutive years, processed 95% of all adhoc data requests within 5 days.
Accurately created reports and dashboards as per delivery schedule using Cognos, Access & Excel
Applied Lean Six Sigma tools to assure tasks were completed on time and were accessible for Development Team/ BA and all appropriate audiences
Deep involvement in migration from SQL Server to MS Access
Developed an IT skill collection tool used to gather skills for the entire IT Division.
This tool was later used to assign resources to corporate projects based on specific skill sets.
Involved in the implementation of IBM Rational Portfolio Manager software - analyzed requirements, developed use cases, conducted testing, developed processes and user documentation, provided training and assistance.
Processed supplier invoices within 10 days to take advantage of a 1% discount which resulted in $250,000 a year in savings.
Distribute gap files to providers to close diagnosis gaps for members which allow the provider to take advantage of annualdiagnosis incentive payments.
Created the Diagnosis Incentive payment files to distributed checks to providers who have closed 100% of gaps for members.
Create member chart chase lists so that medical records can be retrieved from providers to verify a member condition.
Responsible for provider financial analysis, audit & reconciliation of claims and fees schedules for multiple regions.
Involved in Audits related to internal controls to help reduce healthcare fraud
Developed financial settlements and discount reports for contracted and non-contracted hospitals.

We provide IT Staff Augmentation Services!

We'd love your feedback!

Resume Categories

Client Services

Job Seekers

Visa Sponsorship