Healthcare Analyst II Resume

SUMMARY

Analyzes Medicare business processes and translates to business requirements for users within Medicare Operations

TECHNICAL SKILLS

PROFESSIONAL EXPERIENCE

Healthcare Analyst II

Confidential

Responsibilities:

Provide internal audits and support management related processes to help ensure compliance and following CMS guidelines
Creates visually impactful dashboards in Excel for data reporting by using pivot tables and VLOOKUP.
Extracts, interprets and analyzes data to identify key metrics and transform raw data into meaningful, actionable information
Experience in business analyst responsibilities for software tools/application development across various platforms and documenting business requirements
Engages in new project planning/execution to understand business needs and plan testing approach and test details to support high quality process and product development
Assists in developing customer service plans in assigned market/product area including collection, verification, analysis of data and recommendation on next steps
Creates, manages and maintains weekly, monthly, quarterly reports and provide analysis
Performs ad - hoc requests for clients using Excel and custom SQL queries to extract and format requested information
Ensures data accuracy through the creation and implementation of data integrity queries
Enrolled senior citizens in Medicare, prescription drug, dental and vision application plans of their choice.

Credentialing Assistant

Confidential, Pittsburgh, PA

Responsibilities:

Processed provider credentialing information, including verification of data in accordance with policies and procedures, to support network development and credentialing processes.
Assisted in the review, recommendation, approval, and notification processes
Exceeded production goals while maintaining quality
Performed primary and secondary source verifications of credentials according to departmental policy
Maintained Visual Cactus Database

Verification Processor

Confidential, Pittsburgh, PA

Responsibilities:

Accurately processed and invoiced satisfaction of mortgage
Provides effective communication and professional partnership to Loan Officers, Underwriters, Mortgage Assistants
Analyzed financial statements, production reports, tax returns, and credit documentation for accuracy
Surpassed monthly goals of closed loans and received occasional recognition for great customer service