- Goal - oriented, motivated professional with extensive expertise in data analysis and processing procedure updates.
- Competent in strategic logistical planning and tactical execution.
- Compile research and disseminate information regarding data analysis.
- Proficient in customer requirements analysis, including IOM, ISP, SOW, PMR, QMR, and SLA.
AREAS OF EXPERTISE
- Research & Analysis
- Logistics & Tactical Execution
- Strategic Planning/Analysis
- Industry Networking
- Customer Relations
- Competitive Intelligence
- Oral/Written Communication
- System Operations
- Operations Improvement
- Coaching & Training
- Project Management
- Conflict Resolution
PROFESSIONAL EXPERIENCEConfidential, Mechanicsburg, PA
Data Performance Analyst
- Efficiently generate reports to provide accuracy information, error assessments, and deficiencies analyzes, as well as conduct specialized studies to provide thorough feedback of data analysis; restructured production of monthly reports from 5 days to 2.
- Directs weekly meetings with all levels of personnel to discuss performance data, assessment resolutions, and audits; consider changes based on CMS/QASP audit information and IMO/ISO/SOW/QMR/SLA research.
- Conduct monthly cross-departmental calibration to promote processing consistency; scores have improved by 80% over the course of a year.
- Direct, manage, and mentor 27 department reviewers by organizing training sessions to promote accurate and consistent educational assessments; collaborate with reviewers, supervisors, and operations to ensure appropriate assessments and resolutions to adhere to SLA standards, reducing pending assessments by 54%.
- Developed and implemented multiple workbooks that include formulas and links to assist with internal analyses.
- Responsible for internal procedure updates and data collection structure.
- Managed internal process improvement projects; developed system request changes to Oracle database structure to ensure user-friendly experience and efficiency; actively research to identify systems and methods to continually improve the company in a cost-effective manner.
- Conducted inspections related to product delivery system to determine accuracy of processing aspects; recorded and categorized deficiencies and error trends of processing procedures.
- Swiftly finalized tasks with high accuracy levels to achieve SLA standards.
- Appropriately updated and edited processing instructions for operational areas to reflect IOM and CMS research; review and incorporate submitted improvement suggestions to ensure consistent, efficient, and accurate processing.
- Engaged in weekly meetings to discuss operational processing concerns and evaluate internal guidelines.
Confidential, Mechanicsburg, PA
Medicare Appeals Part B Representative
- Received and responded to first level appeal requests from beneficiaries, providers, and CMS.
- Provided accurate verification of initial processing and clerical error corrections, as well as researched and reviewed redeterminations in accordance with CMS policies and regulations.
- Responsible for processing 1490 forms and CERT submissions.
Confidential , Mechanicsburg, PA
- Restructured filing system to boost efficiency and organized supply resources.
- Finalized data entry by recording prices, comparing customer estimates and labor cost, projecting completion dates, and applying debits/credits to accounts.
- Functioned as liaison between proprietors and customers.