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Results-driven Data Analyst with 8+ years of experience leveraging data to improve business performance, drive strategic initiatives, and support operational efficiency. Skilled in advanced Excel, data visualization (dashboards, KPIs), and system analysis. Proven ability to collaborate with cross-functional teams, translate business requirements into actionable insights, and deliver impactful reporting solutions. Strong communicator with a background in claims, finance, and enterprise systems.

Accomplished Revenue Cycle Specialist with 16 years of experience in healthcare billing, claims processing, and accounts receivable management, alongside 5 years in broker contracting and compliance. Proven ability to streamline processes, reduce claim denials, and maintain regulatory compliance. Adept in compliance auditing, financial reconciliation, and CRM systems including Salesforce Health Cloud. Known for exceptional problem-solving, communication, and cross-functional collaboration that drives operational excellence and efficiency.

8+ years of hands-on experience as a Data and Business analyst dealing with Data Visualization, Business Intelligence, and Information Systems in the Healthcare industry. Validated data in accordance with HITECH, HIPAA, HEDIS, SNOMED-CT, ICD coding regulatory standards. Worked with Healthcare Standards such as HL7 messages, FHIR to improve healthcare operations and facilitate interoperability. Managed EMR, EHR, and Epic ambulatory services while working in Epic clinical applications. Analyzed Medicare and Medicaid reimbursement practices and made recommendations, which helped healthcare organizations operate more effectively and spend less money. Worked on P&C insurance experience with emphasis on personal lines and business owner’s lines. Experienced working on EDI Transactions like EDI 835(Medical Claims Payment), EDI 837(Medical Claims Submission) and EDI 270(Eligibility Inquiry), EDI data mapping and migration. Maintained knowledge of diagnostic coding conventions such as ICD-9-CM and ICD-10-CM. Worked on Cerner applications for Citrix Workspace and Relay to process claims and charge for medical services under CMS (1500) and uniform billing (UB04). Demonstrated expertise in conducting process assessments to identify inefficiencies, bottlenecks, and opportunities for automation or improvement within the claims payment process. Used LIMS to manage data and streamline laboratory procedures for better patient care. Ensured compliance with GDPR regulations for handling sensitive patient data, minimizing risk and ensuring privacy and security of personal information. Experienced in multiple SDLC models, including Waterfall and Agile methodologies, and created user stories using JIRA tool. Created process models, and revised the business requirement document (BRD), Use Case Diagrams and flow charts to support Product Owners to identify Functional Requirement Specifications (FRS). Conducted Gap Analysis, Root Cause Analysis, and Impact Analysis to identify discrepancies, underlying issues, and assess the consequences, enabling informed decision-making. Managed User Acceptance Testing (UAT) for healthcare systems and validated the business requirements. Participated in JAD sessions to develop detailed specifications as per user & stakeholder requests. Gathered User Requirements and designed Source to Target data load specifications based on business rules. Worked with Data Architecture teams in Snowflake schema and Star schema for data modeling. Designed and executed ETL processes for healthcare data migration across Cloud and Traditional databases using AWS, GCP, and Azure. Conducted Data Cleansing, Data Validation, Data Verification, Data migration using ETL tools like Talend and Informatica to facilitate data migration processes. Proficient in gathering and analyzing business requirements for EDW initiatives, including data integration, data modeling and ETL processes. Worked on complex ad-hoc SQL queries using Joins, DML, DDL, pivots, views, constraints, and functions using Oracle, MS SQL Server, and MySQL. Worked with T-SQL, Python, XML, JSON scripting to scrape data from multiple sources. Worked with Azure data bricks to speed up the preparation of high-quality data. Conducted analysis on more than one million rows of healthcare data to identify healthcare business trends and develop dashboards and stories using Power BI, Tableau, and SSRS. Utilized SAS to import clinical data from the company's field operations team & ensured that quality standards were met for our customer base whilst carrying out analysis. Utilized HEDIS data to locate care gaps, create interventions, and create dashboards to monitor development against quality measures. Strong experience in QlikView Product family such as QlikView Desktop Client, QlikView Management Console, QlikView Server. Experienced on Teradata SQL queries, Teradata Indexes, Utilities such as M-load, T-pump, Fast load, and Fast export.

Accomplished Business Analyst with a proven track record at Gainwell Technologies, enhancing compliance and risk mitigation through effective project management and team collaboration. Skilled in data privacy and cybersecurity best practices, I've driven process improvements and regulatory adherence, achieving significant operational efficiencies. I excel in any environment, ensuring both team and project success. Seeking to leverage my analyst skills to learn more about strong and successful policies to mitigate risk at each level and establish clear procedures for assessments, prevention, and containment.

Alize crespo

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IT Business Analyst

Help Desk Specialist

Patient Access Representative

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IT Business Analyst

Help Desk Specialist

Patient Access Representative

Penn Foster Career School

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