Summary

Overview

Work History

Education

Skills

Websites

Timeline

Okeyia Williams

Summary

Healthcare Business Analyst and Revenue Cycle professional with 6+ years of experience supporting healthcare operations, EDI transactions, claims processing, enrollment, eligibility, reimbursement, and revenue cycle management. Experienced in HIPAA-compliant transactions including 270/271 Eligibility, 834 Enrollment, 835 Remittance, and 837 Professional and Institutional Claims. Proven ability to analyze complex data, identify process improvement opportunities, resolve claim and enrollment issues, manage vendor relationships, and support system implementations through testing, validation, and business process documentation. Skilled in root cause analysis, denial management, timely filing compliance, stakeholder engagement, UAT testing, SOP development, and operational reporting. Recognized for improving data integrity, enhancing operational efficiency, and delivering measurable results in fast-paced healthcare payer and provider environments.

Overview

years of professional experience

Work History

Business Analyst

North Carolina State Health Plan

Raleigh, North Carolina

06.2025 - Current

Serve as liaison between business stakeholders, vendors, and technical teams to analyze enrollment, eligibility, billing, and data exchange processes.
Develop and execute test cases, test scenarios, and user acceptance testing (UAT) plans for enrollment, eligibility, billing, and EDI-related system enhancements.
Reviewed and resolved enrollment discrepancies by analyzing eligibility files, EDI transactions, carrier responses, and system-generated error reports.
Lead cross-functional meetings and vendor calls to discuss system issues, project updates, operational improvements, and resolution strategies.
Review and analyze raw ANSI X12 834 enrollment files to validate member eligibility, enrollment transactions, coverage changes, and demographic updates.
Investigate and resolve enrollment discrepancies by comparing inbound and outbound 834 transactions with source system data.
Monitored daily enrollment reports and audit logs to identify processing failures, data inconsistencies, and file transmission issues.
Utilized Excel, reporting tools, and internal databases to track enrollment trends, reconcile discrepancies, and generate operational reports.
Ensured compliance with CMS regulations, State Health Plan policies, and healthcare enrollment standards during all enrollment operations.

EDI Claims Analyst (Contract)

Blu Omega

02.2025 - 05.2025

Supported federal healthcare program in claims processing, healthcare data exchange, and operational workflow management to enhance program efficiency.
Gathered, analyzed, and documented business and technical requirements supporting claims processing and reimbursement operations.
Analyzed healthcare data transactions including HIPAA 837 claims and related EDI transactions to support program operations.
Performed data validation, reconciliation, and quality assurance activities to ensure data accuracy and compliance.
Collaborated with federal stakeholders, healthcare providers, business users, and technical teams to identify process improvements and operational solutions.
Created business requirements documentation, process maps, workflow diagrams, and operational procedures.
Conducted root cause analysis of claim rejections, data discrepancies, and operational issues.
Presented operational findings and actionable recommendations to leadership and cross-functional teams to inform decision-making.
Developed training materials and process documentation to enhance user understanding and ensure operational consistency.

Revenue Cycle Analyst

Natera Inc.

10.2023 - 02.2025

Analyzed and resolved complex claim denials and reimbursement issues across commercial, Medicare, and Medicaid payers, improving claim resolution outcomes and reducing accounts receivable aging.
Conducted root cause analysis of denial trends, identifying process gaps and implementing corrective actions that improved claims accuracy and operational efficiency.
• Collaborated with payers, providers, and internal stakeholders to investigate claim discrepancies, resolve payment issues, and ensure regulatory compliance.
Performed detailed review of claim edits, payer policies, medical necessity requirements, and reimbursement guidelines to support successful claim adjudication.
Developed and maintained revenue cycle reports, dashboards, and key performance indicators (KPIs) to monitor denial trends, reimbursement performance, and operational effectiveness.
Presented data-driven findings and performance metrics to leadership, providing actionable recommendations to improve revenue cycle outcomes.
Utilized data analysis techniques to identify reimbursement opportunities, workflow improvements, and process optimization initiatives.
Supported appeals and denial management activities through claim research, documentation review, and payer follow-up.
Partnered with cross-functional teams to improve claim quality, reduce preventable denials, and strengthen revenue cycle performance.
Ensured compliance with HIPAA regulations, payer requirements, and organizational policies while maintaining high standards of data integrity and accuracy.

EDI Enrollment Analyst (Contract)

Innova’s Solutions Agency

03.2023 - 10.2023

Managed end-to-end provider enrollment, ERA, EFT, and payer connectivity processes to support claims submission and revenue cycle operations.
Successfully onboarded and enrolled 50+ providers across multiple EDI platforms, reducing enrollment turnaround times by 15%.
Supported implementation and maintenance of HIPAA-compliant transactions including 270/271 Eligibility, 834 Enrollment, 835 Remittance, and 837 Professional and Institutional Claims.
Conducted enrollment audits, transaction reviews, and data validation activities to identify issues impacting claims processing and reimbursement.
Collaborated with providers, payers, clearinghouses, and internal teams to resolve enrollment and connectivity issues affecting revenue cycle performance.
Investigated transaction failures and enrollment discrepancies through root cause analysis, improving data accuracy and operational efficiency.
Maintained enrollment tracking, implementation documentation, and process workflows to support compliance and audit readiness.
Coordinated stakeholder communications and project activities to ensure successful implementations and timely issue resolution.
Supported testing and validation efforts for enrollment transactions and payer connectivity updates.

EDI Enrollment Analyst I

Olive AI

01.2022 - 04.2023

Supported EDI enrollment, payer connectivity, and transaction management initiatives for 200+ healthcare clients.
Facilitated implementation of HIPAA-compliant EDI transactions including 270/271 Eligibility, 834 Enrollment, 835 Remittance, and 837 Claims.
Performed transaction audits, data analysis, and troubleshooting activities to identify enrollment defects and claim transmission issues.
Conducted root cause analysis and coordinated corrective actions to reduce transaction errors and improve data integrity.
Collaborated with providers, payers, vendors, and technical teams to resolve enrollment issues affecting claims processing and reimbursement workflows.
Validated enrollment records and EDI transaction data to ensure compliance with payer requirements and industry standards.
Maintained project documentation, implementation schedules, and status reporting throughout onboarding and enrollment projects.
Provided stakeholder updates and cross-functional coordination to support project success and client satisfaction.
Assisted with testing activities, workflow validation, and process improvement initiatives to enhance operational performance.