SUMMARY:

• 7+ years of providing Back Office/Revenue Cycle solutions experience
• 6+ years of overall healthcare experience
• 3+ years of Business Analyst experience in Hospital, Healthcare, and Financial Services settings.
• Deep understanding of Revenue Cycle Software to include XIFIN Health Economics Optimization Solutions (very similar to Artiva).
• Assisted with XIFIN implementations, go - lives, testing, coordination, configuration, account creations, metric reporting, stakeholder consultation, documentation, and audits.
• Assisted with XIFIN Centralization of Back Office Business Functions for 20 different healthcare (to include hospital) locations
• Provided consultation for key stakeholders (operations leadership, physicians and other clinicians), conducted statistical analyses to evaluate the clinical and economic effectiveness of initiatives, and to provide relevant information to business decision-makers.
• Excellent communication and analytical skills, with a broad knowledge of Business Process and Business Transformation Implementations.
• Ability to demonstrate skills and knowledge of Relational Database Management System, e.g. Microsoft Access and SQL. System troubleshooting,
• Ability to manage raw data and processes from various sources and full knowledge of the SDLC.
• Team Player with strong Project Management, Spreadsheet Processing, Data Cleanup, Data Quality
• Improvement, Incident Management, and UNIX skills.

• Revenue Cycle Software
• Requirement Analysis
• Customer Relationship Management (CRM)
• Functional Design Development (FDD)
• Technical Design Development (TDD)
• Risk Management
• Project Management
• Change Management
• Client Support
• Workflow & enhancement
• Centralization of Business Offices
• Data Center
• Business Process
• ERP Systems
• Warehousing System
• Asset Management
• Medicaid
• Medicare
• OBIEE
• Active Directory
• SDLC
• MS Excel
• V-Lookup
• Macros
• Crystal report
• Pivots
• MS Project
• MS Access
• MS SQL
• AS400/HMS
• SharePoint
• Unix
• Artiva
• Onbase
• Security & reporting
• ETL
• Apps support

EXPERIENCE:

Confidential

Systems Developer 

Responsibilities:

• Create and implement a cohesive Identity and Access Management Roadmap
• Serve as a key liaison between the IAM team and other departments to develop business cases associated with the CHC and McKesson merger
• Assist in mapping SOX controls to an updated version of the HITRUST framework by gathering and assisting with documentation f the control wording
• Work on security functions associated with identity and access governance, such as policies, process documentation, role management, and access certification within the enterprise.
• Interacts with the business, security, information technology staff, human resources, legal and other groups on identity and access management initiatives, processes, and procedures to ensure the safety and security of the organization’s assets.
• Works closely with the mergers & acquisitions teams to integrate new organizations into the Enterprise Access Governance program (McKinsey & Change Healthcare Merger)
• Design, track and regularly report IAM operational metrics
• Analyze, document and design IAM technical process improvements.
• Interface with Employee Helpdesk. IT operations, Application owners, Data Owners, Resource Managers, and Human Resources to ensure access requests and reviews are processed within the established SLA guidelines and with the necessary approvals.
• Monitors the availability, capacity, and performance of individual IAM systems against service level targets and work with IAM Architecture and Engineering to resolve problems and plan improvements when needed
• Work with the IAM Engineering and Operations teams to ensure IAM solutions are engineered to meet or exceed compliance with enterprise access controls
• Provide and integrate provisioning, role management, authentication, and authorization environment with clearly identified authoritative sources, appropriate governance processes and efficient access control mechanisms

Applications & Interface Systems Developer

Nashville, TN

• Performed all phases of applications systems analysis, designs, integration, workflow, enhancements, and implementation of business needs
• Responsible for designing and creating and performing all related ETL (extract, transform and load) data into the database
• Created workflow, enhancements, and development design documents for management approval
• Applied solutions to issue, debugging prototype through customers and stakeholders interactions Gather requirements from customers and support team before creating design documents for solution
• Performed integration tasks for in-house developed systems and/or purchased hardware and software solutions. (Artiva, HMS, Recondo and Onbase)
• Assisted customers with documentation, training, and usability efforts.
• Participated in accomplishment of continuous improvement objectives for the department.
• Evaluated information gathered from multiple sources, reconcile conflicts, decompose high-level information into details, abstract up from low-level information to a general understanding, and distinguish user requests from the underlying true need

Data Network/ Business Analyst 

Nashville, TN

• Participated in business planning, analysis, and business risk assessment
• Created users, admin workflow and tables in SNOW ( Service Now)
• Configured Service Now application for business processes which includes Incident management, Change Management, and Problem Management.
• Assisted in configuration of Service Now instances such as Email notification, access control and reference qualifiers
• Updated Service Now Wiki, FAQs and Knowledge Base articles
• Protected database by developing access system, specify user level of access
• Performed SWOT and Risk Analysis to Identify and estimate the scope of the major design, development, and deployment of the application.
• Conducted multiple JAD sessions with Shareholders, SMEs and Tech Leads at Bank of America to understand product specifications/requirements.
• Developed Use Cases, Business process flows, Activity/Sequence diagrams for developers and other stakeholders to help communicate application design.
• • Prepared Business Requirements and Functional, Non-Functional requirements and tracked the changes in requirements using JIRA and tableau
• Created Source to Target Mapping Documents based on the Business and System requirements documents
• Worked extensively on data standardization for Master Data Management (MDM) by removing duplicates and incorporating rules to eliminate and standardize data.
• Worked closely with the DBAs to perform Data Mapping and Data Modeling.
• Maintain multiple SharePoint sites while implementing controls and access protocols for content development.
• Develop and design work flows in SharePoint for various business requirements and decision making process
• Perform GAP analysis on system and application infrastructure
• Ensure all artifacts comply with corporate SDLC Policies and guidelines.
• Participated in the User Acceptance Testing (UAT) with large cross-functional teams
• Worked with vendors and stakeholders to clarify technical capabilities and requirements
• as backups or downtime for maintenance
• Examined and evaluated data feeds coming from SNOW to ensure data accuracy and integrity
• Worked with the Service Restoration team and serves as a point of contact for the UBS GPS CC team

Change/Business Analyst 

Brentwood, TN

• Preformed workforce optimization and back-office solutions to seamlessly orchestrate people, processes, and touch points for today's top brands in aviation, financial services, Healthcare, manufacturing, and telecommunications.
• Identified reporting needs to support usage goals throughout the Facility, Division, and Group levels of Aspect Software.
• Performed data analysis of project readiness, creates documentation of interoperability issues and develops strategies for improving performance based on analysis of data.
• Accessed and generated files from different databases.
• Assisted in the development of new databases and the redesign of existing databases and reporting systems used within the Managed Service team.
• Obtained field feedback on usage activities to continuously improve the Managed Services team output.
• Attended Change Review Board meetings for Bank of America, Hyundai capital America, TD auto finance and Health net (Healthcare client).
• Supported Managed Services Operations and Program Management Offices in requesting and communicating granted or changed work window.
• Complied with Aspect NOC change management processes.
• Served as Aspect Proactive Manager and application monitoring resource person.
• Created RFC (Request for Change) applications using both Aspect and Customer required tools.
• Responsible for the successful delivery of Change Management requests following established procedures and methodologies.
• Maintained and improved the change process while staying in compliance with the Customers.
• Established processes and Service Level Agreements (SLAs).
• Monitored stakeholders’ compliance to the change management process.

Business Systems Analyst/ Project Assistant

Brentwood, TN

• Documented Revenue Cycle process memorandums and control matrices accurately and thoroughly.
• Reviewed policies and procedures for various Revenue Cycle functions and provided adequate feed to management regarding policies and procedure.
• Performed audits as defined by management including but not limited to Payer contract. requirements, review of Payer remittance, fee scheduling and contract.
• Team member of the multi-discipline XIFIN implementation / go live.
• Responsible for running reports, task scheduling, payer enrollment, vendor contracts and test codes.
• Documented benchmarks, report changes, format specialty report layouts.
• Generated billing files, data manipulation (extraction and analysis) and trending reports from the cortex system and other databases.
• Testing the accuracy, data analysis of billing and coding activities.
• Maintained user’s confidence and protects operations by keeping information confidential.
• Coordinated all file maintenance duties such as remittance, lock information, gateway.
• Configuration, system monitoring and management/ quality report.
• Interviewed vendors, observed job performance to determine what information is processed and how it is processed.
• Provided consultation for key stakeholders (operations leadership, physicians and other clinicians), conducted statistical analyses to evaluate the clinical and economic effectiveness of initiatives, and to provide relevant information to business decision-makers.

Medicaid & Medicare Program Associate

Nashville, TN

• Reviewed the Tennessee State Medicaid and Medicare compliance policy to ensure that documentations are strictly adhere to.
• Liaised with health insurance providers in solving claim disputes.
• Worked closely with the Tennessee State auditors during agency wide surveys.
• Processed the Social Supplemental Income Checks for clients and completed all government enrollment forms and applications relating to TennCare, Medicare, Medicaid and Tricare.
• Worked and communicated with behavioral analysts, speech and occupational therapists, primary care physicians, conservators, psychiatrists, independent support coordinators and other stake holders.
• Developed, coordinated, and implemented remediation plans to alleviate identified control deficiencies.
• Ensured accuracy of new business claims, notes, payments, and new claims interfacing from other systems.
• Created business designs documents by translating business requirements into business detail.
• Completed deliverables based on project plan and SDLC variables.
• Attended weekly meeting with TennCare stakeholders to discuss the status of work orders.
• Created Enrollment business rules for Operational Decision Management.
• Gathered, elicited, and validated Enrollment & Eligibility requirements for business processes, interChange, and Federal Mandates for small, medium, and large projects.