Business Analyst Resume

TECHNICAL SKILLS:

Software: Golden, MS SQL Server 2012, Excel, Word, Outlook, PowerPoint, Visio, Macess, TruCare, CenProv, DST Pricer, Service Now

PROFESSIONAL EXPERIENCE:

Business Analyst

Confidential

Responsibilities:

Perform detailed analysis on assigned tasks, recommend potential business solutions and assist with configuration, and correction of provider loads as well as creating guides for contracts.
Identify ways to enhance performance management and operational reports related to new business implementation processes.
Develop and in corporate organizational best practices into business applications.
Lead problem solving and coordination efforts between various business units.
Assist with formulating and updating departmental policies and procedures.

Senior Product Performance Analyst

Confidential

Responsibilities:

Lead various sub - projects and initiatives.
Project Managing to ensure Projects were completed within given turnaround times.
Organizing excel spreadsheets and preforming comparisons to other excel spreadsheets for management or upper management depending on whom the task was for.
Worked with SIU to ensure quality, compliance and monitory amounts were correct.
Identify required product modifications and enhancements.
Monitor and track industry demands and competitor enhancements.
Assist with product development strategy formulation.
Serve as product subject matter expertise for assigned products and team members.
Build trust-based relationships with peers within health plans.
Assist with train the trainer on new product and program enhancements as needed.

Business Analyst II

Confidential

Responsibilities:

Identify and analyze user requirements, procedures, and problems to improve existing processes.
Perform detailed analysis on assigned projects, recommend potential business solutions and assist with implementation.
Identify ways to enhance performance management and operational reports related to new business implementation processes.
Develop and in corporate organizational best practices into business applications.
Lead problem solving and coordination efforts between various business units.
Assist with formulating and updating departmental policies and procedures.

Confidential

Responsibilities:

Insurance verification. HIPPA compliant
EDI claims, Check runs, C360 Projects
Pay Span, and Emdeon.
Assisting with Authorization Issues through research and continuing with the authorization department to ensure I had the up-to-date information.

Provider Relations Specialist

Confidential

Responsibilities:

Completed Corporates Emptoris
Completed Corporate Contracting
Monitor and track industry demands and competitor enhancements.
Serve as product subject matter expertise for assigned products and team members.
Build trust-based relationships with peers within health plans.

Claims COB Analyst III

Confidential

Responsibilities:

Insurance verification. HIPPA compliant
EDI claims, Check runs, C360 Projects
Pay Span, and Emdeon, and EDI
Assisting with Authorization Issues through research
COB and TPL research and annualized for valid payments.
Processed claims to pay per COB/TPL rules and regulations.
Performed adjudication of complex coordination of benefits claims payment methodologies; and
Assisted with special projects for the FL market and assisted with load balancing for other markets.