Skilled Business Analyst with record of success breaking down and improving business systems. Collaborates well to test, implement, refine and enhance systems and meet current and expected business needs. Excellent research, reporting and communication strengths developed over a 11-year career.
Overview
12
12
years of professional experience
1
1
Certification
Work History
EDI Business Systems Analyst II
Centene Corporation
12.2018 - 12.2023
Utilize various software tools like Oracle TOAD SQL, Postman, and Soap UI to run queries and API calls for testing and member checks, ensuring the accuracy and reliability of data and services and MongoDB to review any exception handling errors.
Collaborate with stakeholders to conduct User Acceptance Testing (UAT) and obtain approval for deploying changes from the testing environment to production.
Serve as a Business Analyst (BA) on call quarterly, gathering and analyzing business requirements, and assisting in defining project scope and objectives
Manage and maintain Control-M jobs, including creating new jobs, modifying existing ones, and troubleshooting job-related issues to ensure smooth and efficient job execution.
Performed internal system acceptance to deliver well-tested enhancements and meet business requirements.
Reduced project completion times by effectively managing cross-functional teams in agile environments.
Communicated and explained business requirements to team members to understand and implement functional demands.
Collaborated with upper management to drive strategy and implement new processes.
Collected, defined and analyzed business requirements.
Helped deploy system enhancements to improve field operations.
Improved systems with addition of new features and infrastructure.
EDI Technical Analyst
TriZetto Provider Solutions, a Cognizant Company
08.2015 - 12.2018
Conduct comprehensive research and analysis on a variety of healthcare claims-related matters within the designated knowledge base.
Provided exceptional support for end-users by addressing technical concerns, reducing downtime, and improving user experience.
Balance Coordination of Benefits (COB) claims to ensure accurate claim adjudication and reimbursement.
Read and interpret Electronic Data Interchange (EDI) file sets, including 837, 835, 270, and 271, to extract pertinent information.
Verify batch or single eligibility accurately and efficiently, ensuring proper coverage for claim submission.
Coordinated with external vendors during system implementations or upgrades, ensuring timely completion within project constraints.
Applied knowledge of IT best practices to tackle new challenges and make educated decisions.
Cultivated professional working relationships with internal personnel, vendors and suppliers.
Stay updated on industry regulations, trends, and best practices related to healthcare claims processing.
Enhanced system performance by identifying and resolving technical issues through thorough analysis and troubleshooting.
Technical Support Application Analyst
Macy’s Call Center
01.2012 - 08.2015
Worked as a dedicated Account Manager for the Large Tier level retailer – Bloomingdales.
Assisted with troubleshooting webpage, enabling Java Scripts, internet options and compatibility settings
Accommodated credits for exclusive account types, reviewed accounts to extend credit balances, and awarded accounts based on client performance.
Trained end-users on new applications and features, facilitating a smooth transition during software rollouts.
Served as a liaison between technical teams and key stakeholders, ensuring clear communication of project goals while managing expectations effectively.
Trained staff on proper use of systems and conducted orientation seminars.
Established and maintained a strong working knowledge of internal systems to provide comprehensive support for end-users, identifying potential areas for enhancement.
Maintained detailed documentation of all application updates and changes to facilitate efficient troubleshooting processes when required.
Education
No Degree - Art Studies
St. Louis Community College
St Louis, MO
05.2014
Skills
Revenue Cycle Management Adaptability
Project Management
SQL Proficiency
User Acceptance Testing
Stakeholder Engagement
Cross-Functional Collaboration
Research and Analysis
Process Documentation
Production Support
ORACLE SQL
Agile Expertise
Quality Assurance
Accomplishments
Served as a IT project lead of behalf of EDI with assisting a new healthplan go-live to production. This was successfully achieved on 01/01/2023.
Served as a Mentor to several mentees during my tenure at Gateway EDI.
Became a MAKE MAGIC award winner in 2014 during my tenure at Macy's due to my exceptional QA performance to our Macy's/Bloomingdale clients.