Professional Software Engineer / Team Lead / BA / QA

A self starter with 10+ years experience with project requirements gathering, analysis, task assignments and development of in-house applications, focused on the accounting and finance requirements of one of the leaders in medical claims billing and re-pricing using proprietary software applications. Interested in local contract/permanent position.

Proficient in: SQL Server 2008, SQL 2005, SSIS, ASP.Net , DTS, MS Access, FrontPage, Photoshop, Crystal Reports, Visio, , MS Project , Visual Basic 6 Familiar with: WPR, C#.Net , Great Plains, Java, SSRS, Data Warehouses and XML, 837 & G12 formats, Agile and SCRUM methodology; exposure to silverlight, Ajax. Our applications and database are hosted in a data center and accessed through Citrix. Detailed oriented with excellent communications and writing skills. Ability to work independently and also in a team environment

Professional Experience

Application Programmer /Analyst Oct 1998 - Present Confidential. Atlanta, Ga Part of a highly skilled team focusing on quality, continuous improvement and customer satisfaction, in a fast paced and very demanding environment. - Participated as needed on projects to define, model, design, analyze, develop, test, QA, implement, debug, document and support proprietary healthcare claims processing software applications. I was frequently involved with in-depth analysis on business problems to assist management in product decisions. Interview, develop and implement the user's requirements, tasks specification documentation and a technical plan to meet project business needs. I work independently or lead small project teams of 2 to 5. Also provide ad-hoc query reports, data analysis and DTS / SSIS jobs as needed by management.

Sept. 1995 - April 1998 Confidential Atlanta, Ga Support Desk: Maintaining the staging inventory database, hardware and software support, training and assisting users. Some reporting in Peoplesoft.

April 1984 - Aug. 1993 Confidential Port Jefferson, New York Register Nurse for a 265-bed community hospital. My responsibilities included ER triage, admission assessment, developing nursing care plans, telemetry, med-surg and peds, patient care and teaching.

Jan 1983- Jan 1984 Confidential Glen Cove, New York Registered Nurse/District Leader for a 200-bed community hospital, primary focus on Cardiac Telemetry.

Subsequent employment experience includes retail buying positions with Lord & Taylor and Macy's in New York.

Education BS in Computer Science AAS Nursing

Additional Courses: Advance VB, ASP, SQL Server, VB.Net, Project Management, C#.net, XML and recently attending seminar for MS VS 2010

Project Highlights

On-going: I am the primary contact for the business users, troubleshooting defects related to three of our proprietary applications ( claim repricing, accounting, invoicing and Sales). I am responsible to identify and address application problems quickly and to work with our internal customers to understand and identify solutions to their enhancement requests. Also, I participate in training our users on new application features. In addition, I am a mentor to the newer members of the IS department.

2010 EDI Client WM Mappings. This was an SSIS package to pull data from xml to compare with historical data is SQL, used to QA medical claims mappings in from 837 format to our environment.

2010 Dental provider matching of claims data with our provider database basedon providers Tax ID or name and region.

2010 Great Plains SQL Upgrade: Testing / QA role. This is a upgrade the Accounting Department's Great Plains SQL database to SQL 2008, required testing, code re-writes and optimizing stored procedures.

2009-2010 Partial Paid Invoices: BA / Team Lead / Design / Developer / Trainer This is an SSIS package to control the processes that were developed to pull the invoice data and the associated cash, credits and debits, from the Great Plains database together into one set of tables. This process allows us to include partial payments and debits in the calculations of our fee liability and to maintain monthly audit records, in the database. This project included the reporting needs including fee analysis and trends through BI .

2008 NPPN 2nd Transition State: Team Member This project identified the modifications needed to create and utilize a crosswalk table, for the ability to seamlessly processing HCFA & UB within the CAI system from our FTP site, due to the acquisitions of NPPN company, both prior to and after the clients' migration to the CAI system. Our top priority was to minimize disruption in client service and to maintain separation of accounting processes for these clients.

2008 NPPN Claim Routing Gaps: BA / Team Lead / Developer / Tester The purpose of this project was to capture the requirements for the modifications needed to manage the routing gaps between CAI and NPPN, the company we had acquired. This gap analysis was used to identify process enhancements needed. It was also used to implement exception handling tools, business rules and to manage the additional NPPN claim volume.

2008 ERS: BA / Team Lead / Developer This was a new process to create, populate and maintain a database of standard discounts per medical provider and region.

2008 CAI SQL upgrade: QA / Testing We upgraded our SQL database, to benefit both internal users and clients, with better performance. required testing, code re-writes and optimizing stored procedures.

2007 RNC: ( Regular & Customary ) Team Member/ Developer / QA / Tester In response to clients' requests, processes were developed to identify dis-allowed line items. These changes required modifications to the EDI import process, savings calculations, invoicing, administration Fees and statuses codes.

2007 EZPay Responsibility: BA / Team Lead / Design / Developer / Trainer This was a new product to be offered to specific client, to provide a process to determine the financial responsibility between payers and insured and display with crystal reports and much more.

2007 Data Archiving: Team Member/ QA/ Testing This was a database archiving project to reduce the table sizes in our production database, therefore, allowing applications to operate at peak performance, allowing us to support more customers and many more transactions. The process developed is now repeated quarterly.

2007 Dental: Team Member / BA for file transfer / Team Lead / Design / Developer / Trainer This was a client specific product created to allow clients in our dental claims program, to preview results. This project incorporated the use an ETL process to handle the provider demographics, updates, opt outs and disputes as they relate to providers, specialty, diagnostic codes, fee schedule and regions.

2007 CDA Continual Discount Arrangements): Team Member / Developer This project required modification and enhancements to the UI, for this CDA process, to allow users to update, delete, replicate, view and enter new CDAs, and to create an security trail.

2006 Commission Contractual Project: BA / Ad hoc reports I worked with an outside attorney, to provide reports and analysis as needed to support his legal case.

2006 Provider Optimization: Team Member/ Developer This was an internal project to identify the best PPO or Negotiation Discount at the Region / Provider TAX ID level for re-pricing purposes. The best PPOs are automatically updated monthly, based on historical data.

2006 Reports Phase III: Team Member/ BA for accounting / QA / Tester This was Phase III of our reporting project to enhance the internal company wide reporting platform.

2006 Provider Matching: Team Member/ BA / QA This was a new internal process to incorporate our Lodestone medical provider database to populate the addresses, office, phone numbers, faxes for all USA physicians and hospitals, that data is now used to validate provider data that is imported into our database from the claim files.

2005 Provider Name Standardization: Team Member/ Developer As the first part of the new Provider Matching project, this process was created to store professional provider non-facility names by standardizing the name components into first, middle, and last names, along with original provider info provided imported with medical and dental claims.

2005 Medical Repricing Team Member/ Developer This was a client specific product created to allow clients to preview re-pricing results, when utilizing specific providers. This project incorporated the use an ETL process to handle the provider demographics, updates and disputes.

2004 PEPM Invoicing automation process: BA/Team Lead/Design/Trainer This was an Per Employee Per Monthaccounting process to automate our client monthly billing process and associated Fees. This process provides a user interface, to enter and edit the monthly rates and to calculate the fees, provide summary and detail crystal reports in window forms and in excel, and to post invoices to the accounting journal.

2002 Reporting Project II: Team Member/ BA for accounting / QA / Tester This was Phase II of our reporting project. It provided multiple business reports for sales, accounting and operations. Most of these reports were created in Crystal Reportsand Excel, some went to a text file.

2002 MKI (Monthly Key Indicators ) reports: BA / Team Lead / Design / Developer / Trainer This was an internal monthly analysis report designed to collects, analyzes, and evaluates our data to determining trends, identify patterns, bench marks and profitability. It compiled the accounting information such as invoices, fees, credits, cash, refunds and rates and display the results in grid and graph format.

2002 Automate Accounting Credit Import process BA / Design / Developer / Trainer This was an enhancement to our accounting application to provide the ability to import excel file from our clients via the user interface to post credits to the journal.

2001 Automate Accounting Write off process: BA / Design / Developer / Trainer This was an enhancement to our accounting application to provide the ability to import excel file via the user interface to create write-offs in the journal.

2001 Invoice Revision History: BA / Design / Developer / Trainer Invoicing process requested by our controller to be used to track invoice history by appending a letter; "A". "B", "C" ... to the invoice number, each time it is revised. This required modifications to the invoicing COM object, reports and the daily DTS package for Great Plains.

2000 Migration from MS Access: to a SQL Server database: Team Member/ Developer This was a major project using the full IS term. This required rewriting our stored procedures and modifying application calls and imbedded SQL so that they could access a SQL database.

Prior to 2000: Application support and Enhancements: Most of my work at this time, related to application enhancements, reports and defect fixes to the proprietary software.