- Highly motivated and focused professional with advanced data analysis skills and extensive experience in customer service, CRM and tech support.
- Proficient in developing and executing policies, programs and procedures related to healthcare.
- Performs exceptionally well in fast - paced, high-pressure, cross-functional environments.
- Tech-savvy specialist highly skilled in improving the efficiency of operating information systems and databases.
- Dynamic leader adept at providing guidance to teams in order to meet customer needs and business goals.
- Excellent communicator able to achieve collaboration at all levels and with all stakeholders.
- Well versed with medical terminology and ICD-10; in-depth knowledge of HIPPA and various X12 formats.
- Regarded for high attention to detail, work ethic, and the ability to complete projects within schedules.
- Seeking a challenging position within a progressive organization to contribute acquired skills and knowledge to its smooth and successful operation while being of value to its clients.
CORE SKILLS AND COMPETENCIES:
- Data Analysis & Management
- Project Management
- Complex Problem Solving
- Customer Service
- Program/Policy Implementation
- Conflict Resolution
- Account Management
- System Vendors & Billing Services
- Process Documentation
- Benefit Administration
- Staff Training / Supervision
- Adaptability & Multitasking
Applications: TriZetto Facets, Microsoft BizTalk Server, Word, Excel, PowerPoint, Access, Outlook, Visio
Operating Systems: Windows XP/7/10. Apple IOS 11 and Mac OS 10.13
Other: SQL, Tableau (basics), Agile development processes and methodologies (familiarity)
Confidential, Teaneck, NJ
- Create dashboards of daily operations, also providing assistance to management as needed.
- Train and mentor new team members on EDI Analysis, making recommendations and helping with workflow.
- Effectively maintain the QA processes, procedures and methodologies. Timely prepare relevant documentation.
Confidential, New York, NY
EDI Data Analyst
- Demonstrated strong leadership skills in supervising day-to-day operations and training new employees.
- Tracked daily transmission and processing of Eligibility and Claims files from BizTalk.
- Regularly analyzed 5010 EDI transactions to identify the changes in the segments and data elements.
- Engaged in data fix/recovery/replay operations for reporting cleanup of HIPAA Compliant EDI transactions.
- Customized, reported, analyzed and enhanced EDI transaction, keeping spreadsheet reports and statistics.
- Served as a liaison between external Business Stakeholders and internal operations.
- Provided end user feedback in Agile development for new software transition.