TECHNICAL SKILLS:

Database: Oracle, MS SQL, SQL Server, MS Access

Application: MHS Power (AS400), EPIC, E - primus

Reporting: Tableau 9.0, Power BI, SPSS

Office: Advance Excel (Pivot, VLOOKUP, hookup, graphs, charts, statements), PowerPoint, Word

Others: Medical Billing (Medicare, Medicaid, HMO, private), CMS 1500, UB04, Account payable (bank and credit reconciliation, payroll reconciliation, vendors mgmt. ), Account receivable Aging account, collection, account reconciliation, month end closing

PROFESSIONAL EXPERIENCE:

Confidential

Provider Analyst

• Perform data extraction and validation for new, changed and termed providers.
• Generated biweekly, monthly and quarterly provider reports as per state and department requests.
• Created monthly and quarterly MediCal directory. Done monthly provider reconciliation
• Regularly used Access and SQL queries for reporting purpose.
• Uploaded the reports on SharePoint and website

Confidential, San Francisco, CA

Financial Rebate Analyst

• Reporting - Variance and reporting analysis against forecast for P &L, month end closing, reconciliation and account reconciliation.
• Analysis- evaluate contracts for rebate payment analysis, sales data extraction, validate rebate data and analysis, ad-hoc reporting, analysis and resolution o disputed rebate claim data
• Data - Performed data mining and validation on large excel data set with over 300,000 lines
• UAT Testing-Comparison testing between legacy and SAP HANA to test business logic.
• Use of tableau 9.0 for determining sales trends.

Software: include Excel (Advance formula, sum if, Pivot, Table, graph) and SAP HANA.

S/Q: Access, SAP HANA, Excel, SQL

Confidential, NYC

Sr Business Data Analyst

• Created dashboard on Tableau to track the monthly and quarterly enrollment and termination of members
• Data ETL: Develop end-to-end enrollment (834) data migration from extraction of data, conversion to creation of AS400 ready format and creation of load program to upload the data to AS400.
• Created preload, invalid, data readiness and post load reports displaying data at different ETL lifecycle.
• Developed end to end data migration process of extraction of data, conversion to AS400 ready format and creation of AS400 load program to upload data to AS400
• Configuration: Worked on Configuration set up for contracts such as setting up Fees Schedules for different type of Service codes/CPT/Revenue codes, Pricing Set, Pricing Agreements, Pricing Method, APG’s pricing method, Claims class codes, Provider Templates as per Medicare, Medicaid and Exchange LOB’s. Monitor and overseas daily batch processes in Admin console to jobs in process area.
• SQL: Created and executed SQL queries for data extraction and reporting in both production and test environment.
• Data Analysis: Run SQL queries on large complex dataset with multiple tables to extract data for analysis and reporting purpose. Validate source data for accuracy and errors.
• Data Mapping: Data mapping providers to clearing houses for accurate Electric Remittance and remittance adjustment reason codes,
• Reporting: Generate dashboard reports in Tableau for Small Business Health Option Plan (SHOP).
• Performed the trend line analysis for Marketplace, SHOP, enrollments and terminations using Tableau
• Testing: Performed User Acceptance Testing (UAT) for the quarterly release before moving to production. Worked with third party vendor for all cases related to system changes/ application modification/screen modifications. Write test plan and cases, technical requirements along with sample data, screen shots, and upon release perform UAT testing.
• Heavy use of advance excel(VLOOKUP, pivot table and charts, statements, data validation and cleaning), Tableau 9.0, AS400(legacy)

Confidential, NYC

Database Intern

• Project Planning: Developed project plan, requirement gathering via interview session, performed logical and system design, tested design with added queries and reports and tested the final implementation.
• Project Mgmt.: Managed a complete project from requirements planning, gathering, design, develop, test and implement moderately complex database using MS Access and SQL queries.
• Data: Cleansed, validated and formatted excel data. Imported cleaned excel data to Microsoft Access to check functionality as requested.
• Access Database: Developed comprehensive user-friendly database for HIV prevention department using forms, queries and macro.

Confidential, San Jose, CA

Accounting Analyst

• Claims: Examine approximately 600 medical claims daily. Claims verified against diamond system for the date of service, eligibility and insurance validity for payment, pending or denied.
• Claim Errors: Denied claims were send to provider with EOB message. Pending claims moved to different queue with unique codes for further research.
• Data Verification: Paid claims verified for diagnostic codes, facility code, payment plan and eligibility prior to moving to AP queue.

Confidential, Los Gatos, CA

Business Office Manager

• Supervised and managed six-team member.
• Financial: Prepared and analyzed monthly and quarterly financial analysis report.
• Billing: Managed Medicaid, Medicare, HMO, third party and private monthly billing of $2 million with an average monthly collection rate between 95-98%.
• Result: Decreased total percentage of account receivable aged over 90 days to from 20% to 4 %.
• Accounting: Responsible for full cycle billing from admission, pre bill, coding, copay collection, pre-bill check, billing, payment posting and A/R collection, general ledger posting. Assisted in month end closing, account reconciliation, bank and trust reconciliation. Verified invoices, credit memos, expense report, vendor management and reconciliation of accounts.
• Contract: Assisted in annual insurance contract rate negotiations and renewals.

Confidential, Mountain View, CA

Sr Accountant

• Accounting: Accurately review and approve invoices, cash receipts, journal entries, and account reconciliation.
• Variance analysis against P &L statement.
• Reconciliation: Review and reconcile Account Receivable aging, bank statements and remittance details to ensure all payments, open invoices and credit memos applied accurately.
• AR Recon to GL report and close AR module on month end close.
• Bank, cash and credit card reconciliations.

Confidential, Campbell, CA

Business Office Manager

• Managed team of six people in operation, accounting and HR. Cross train staff and prepare training document for business office procedure using screen prints,
• Responsible for processing invoice, expense reports and contract payment. Maintained vendors’ W-9 on all vendors and performed annual 1099 reporting.
• Responsible for new vendor contract, invoice, account payment and reconciliation.
• Overseas the proper clinical documentations for billing and provide updates to physicians and hospitals.
• Keeping track of monthly patients’ stats.
• Kept track of mileage, visit type, schedule updates of Operation Therapist, Physical Therapist and Speech Therapist visits for all the patients.