PROFESSIONAL EXPERIENCE

Senior Business IT Analyst

Confidential, GA

Responsibilities:

• Serve as client advocate and a primary point of contact for Workers Compensation and/or Property and Casualty implementations
• Collaborate with Business Units including Operations, BI and Development to ensure successful project launch
• Demonstrate a clear understanding of client’s core business and effectively communicate the desired end result of projects/analysis to company’s operational units through documentation
• Liaise with both technical and non - technical contacts to ensure deliverables are met using Agile methodology
• Identify and resolve complex client implementation issues and internal development needs for requirements
• Perform quality assurance of production changes and improvements
• Create user stories in VersionOne from stakeholder feedback for change requests and new product development
• Configure clients in Oracle database using SQL inserts and in pharmacy processor’s system using ServiceNow
• Maintain Functional Requirements, Project Plans and Test Case Plans throughout each SDLC
• Gather requirements from client and translate into technical documentation including project scope, data mapping, business rules, data flow, and ftp protocol for Engineers and IT Operations
• ETL initial data files from client system into company database and facilitation of clean up
• Create and execute SQL statements in production to analyze claim, invoice and payment data and QA client files
• Monitor production data at go-live and provide post implementation support
• Troubleshoot failed jobs by reviewing JavaScript code for errors
• Mentor and coach Junior Analysts and support internal customers like Finance, Account Management, and Sales
• Produce training documents and SOPs and diary new processes for new and existing hires
• Manage major account remediation project and lead team of BAs on migration project from legacy platform

Senior Network Support Analyst

Confidential, GA

Responsibilities:

• Establish and maintain AS2 connections and Interconnects
• Troubleshoot FTP, AS2 and VAN issues using Unix to research system activity
• Assist trading partners with migration testing to go-live
• Provide second tier support via tickets and phone to VAN customers

Senior Business Analyst

Confidential, GA

Responsibilities:

• Connect vendors and suppliers for e-commerce using file translation and EDI technology
• Provide post sales project management from contract signature to production
• Lead and mentor team of 5 Junior Business Analysts with onboarding and continuous training
• Maintain supplier documentation based on vendor specifics and create and manage internal reference documents
• Manage portfolio of 80 plus global suppliers for electronic purchase orders, invoices and payments
• Create field definitions for mapping department on multiple file types including ANSI, XML, CSV, and fixed width
• Provide guidance to suppliers for importing/exporting purchase order/invoice files using various ERP systems
• Work with offshore team of engineers on development of business solutions
• Set up connectivity via VAN, AS2, FTP or web portal
• Troubleshoot file rejections and act as liaison between suppliers and their customers
• Provide issue escalation pathways and document and manage all partner issues
• Consistently exceed quarterly objectives

EDI Manager

Confidential, GA

Responsibilities:

• Manage daily EDI claims transmissions and acknowledgement files
• Test and implement claims files to new payers and existing payers
• Update file formats from NSF to ANSI to accommodate HIPAA mandates
• Grew connections from 15 to more than 45 over 2 years
• Manage contracts between providers/payers and payers/clearinghouse for B2B connectivity
• Support electronic claims clients and relay payer rejections including ICD-9 and CPT code errors
• Work trouble tickets via telephone, e-mail or web chat including researching required information
• Provide product training and input on functionality and processes
• Maintain payer database and confirm data in new requests from users
• Assist and train new employees with PC applications, software installs and network access
• Create forms from payer documentation in order to expedite enrollment process

Implementation and EDI Enrollment Analyst

Confidential, GA

Responsibilities:

• Develop training manuals and implementation documentation to create support and registration processes
• Conduct on-site training classes for payer representatives to market to and implement new clients on web product
• Manage pilot site accounts and work directly with payers to assure system functionality end-to-end
• Assist Product Management and Marketing teams with redesigns of registration process on website
• Perform QA on new releases and submit ER’s as needed
• Support vendor, payer and billing service accounts and provide technical training
• Implement new clients via phone and web and instruct customers on uploading claim files for mapping
• Provide weekly status reports on new and pending clients to the account managers
• Educate Sales and Support to offer the best service and products to customers
• Generate logins for new B2B clients using HIPAA standards
• Increase customer usage by 34 percent over 3 months by implementing a follow up process
• Work with payers, Operations Department, and customers to research missing or rejected claims
• Submit CRs to Development for enhancements to systems as needed by payers and for data restores for clients
• Instruct employees on support tools, process flows, and products and services provided by company
• Develop reference material for internal and external customers

Senior Enrollment Coordinator

Confidential

Responsibilities:

• Lead data entry team to provide support and supervision with new enrollments
• Administer new submitter contracts for 12 states to utilize company’s systems
• Manage and support accounts of 3 major EDI payers to ensure customer satisfaction
• Set up new POS clients on database for E-commerce transactions
• Create work flow and registration forms to expedite new enrollments

TECHNICAL SKILLS

Skills and Tools: EDI, E-commerce, Integration, Migration, Mapping, Project Management, Implementation, PBM, Healthcare, Invoicing, Order Management, Workers’ Compensation, Property and Casualty, Ancillary, Training, Documentation, Process Management, QA, UAT, Testing, B2B, Requirements, Six Sigma, Agile, SDLC, Data ETL, HIPAA, PGP, sFTP, AS2, VPN, RDC, VersionOne, JIRA, Confluence, SharePoint, WebEx, Microsoft Office (Word, Excel, Access, Outlook, Power Point, Project, Visio), IE, Mozilla Firefox, Chrome, WinZip, CRT, PFE, WS FTP, FileZilla, WinSCP, ProComm, HyperTerminal, Axway Secure Transport, Studio Mapping, MS SQL Server, DzSoft Perl Editor, Notepad ++, Softshare, GXS Trading Grid, ERP (QuickBooks, Peachtree, Oracle, SAP), CRM (ServiceNow, Ace, Lotus Notes, SalesForce.com), File Analysis (XML, Delimited, Fixed Width, Edifact, JSON, ANSI (835, 837, 810, 210, 110, 276/277, 850, 997)