Cylita D’Ann
Land O’ Lakes,FL
Summary
Software-savvy quality assurance professional committed to confirming proper functionality and usability of software products before release. Plans test schedules and strategies according to project scope and delivery dates and monitors and tracks bug resolutions. Reviews software documentation to verify technical accuracy and completeness and to mitigate risks.
Overview
24
24
years of professional experience
Work History
IT Quality Control Analyst
Elevance
Tampa, FL
07.2014 - Current
- Performs UAT, System Patch testing and production validation for new implementations, process improvement projects, and claims special projects.
- Participates in weekly meetings with IT department.
- Trains and coaches existing and new employees on multiple case types and internal control processes.
- Develops test scripts utilizing comprehensive business requirements, functional documentation and processes.
- Provides analytical, planning and coordination support on projects as assigned, reviewing, interpreting, analyzing and illustrating data to stimulate and support enlightened decision making.
Documentation Analyst Lead
Elevance
Tampa, FL
06.2013 - 06.2014
- Updated end-user documentation to support system changes.
- Applied analytical and technical skills to implement business marketing solutions.
- Consulted with development team to evaluate technical documentation needs.
- Collaborated with quality assurance team to comply with regulatory requirements.
- Developed and conducted training for documentation to ensure consistency and quality.
- Provided guidance to lower-leveled analysts and coordinated work flow in unit.
Operations Expert
Elevance
Tampa, FL
05.2010 - 06.2013
- Recommended new and modified processes and procedures to reduce claims errors, taking into consideration business requirements and system limitations
- Performed user acceptance testing to ensure new calculations were loaded correctly in the Facets claims systems.
- Created and facilitated training modules for process improvement and coaching opportunities
- Facilitated new hire training and training for new systems, processes, regulations and products pertinent to assigned staff.
- Applied excellent problem-solving, process development and strategic implementation skills to lead and support all areas of operations.
- Strategically coordinated operations according to objectives and capabilities, effectively allocating resources to meet demands.
Claims Analyst II
Elevance
Tampa, FL
10.2008 - 05.2010
- Responsible for processing all intermediate level claim transactions.
- Maintained strict confidentiality with all personal data as per company guidelines.
- Interpreted, understood, and applied product contracts and fee schedules for assigned markets when processing claims.
- Processed provider referrals, primary care encounter information and fee for service claims received in both paper and automated formats into the claims systems
- Implemented appropriate claims processes and courses of action when adjudicating claims, to include new day claims, claims requiring research, claims requiring adjustments and claims associated with other health insurance coverage.
Provider Services Representative
Elevance
Tampa, FL
06.2007 - 10.2008
- Responsible for responding to inquiries from members and providers to clarify benefits, resolve claim issues, provide appeal status, and effectively communicate authorization/referral information.
- Educated customers about billing, payment processing and support policies and procedures.
- Assisted with problem payments, directed and assisted in filing claims correctly and in a timely manner.
- Functioned as an information source to members, providers, benefit representatives and various company department staff.
Technical Claims Specialist
Coventry
Tampa, Fl
01.2005 - 01.2007
- Supported department goals to improve quality and provides feedback to management about staff developmental needs while identifying performance gaps and develops relevant training.
- Investigated and facilitated the resolution of claims issues, including incorrectly paid claims, by working with multiple operational areas and health plans and analyzing the systems and processes involved in member enrollment, provider information management, benefits configuration and/or claims processing.
- Coordinated the efforts of several internal departments to determine appropriate resolution of issues within strict timelines.
- Supported and attended conference calls for markets-All Calls Account Management for supervisors and upper management.
- Recommended new or modified processes and procedures to reduce claims errors, taking into consideration business requirements and system limitations.
- Created exception memos, reviewed business requirements.
Medical Review Analyst
Concentra Integrated Services
Tampa, Fl.
01.2002 - 01.2004
- Responsible for auditing worker's compensation claims.
- Maintained accuracy, completeness and security for medical records and health information.
- Input data into computer programs and filing systems.
- Ensured appropriate fee schedule is applied.
Pharmacy Bill Reviewer
Pharmerica
Tampa, FL
01.2001 - 01.2002
- Audited worker's compensation pharmacy bills.
- Maintained up-to-date knowledge of product and service changes.
- Implemented crosswalk of pharmacy codes from integrated systems.
- Increased efficiency and team productivity by promoting operational best practices.
Automated Logistics Specialist
United States Army
01.1997 - 01.2001
- Provided daily customer service to supporting units.
- Established and maintained stock records and other documents such as inventory, material control, accounting, and supply reports.
- Reviewed and verified quantities received against bills of lading, contracts, purchase requests and shipping documents.
- Completed work orders and recorded supply readiness. Created and disbursed dispatch schedules to executive leaders and stakeholders.
- Maintained excellent working relationships with customers by efficiently responding to inquiries and complaints concerning work orders, invoices and shipments.
- Established operations procedures and complied with military policies.
Education
Bachelor of Science - Cyber Security
Saint Leo University
Saint Leo, FL04.2019
Associate of Arts - Liberal Arts
Saint Leo University
Saint Leo, FL01.2016
Skills
- User Acceptance Testing (UAT)
- Operational Policies and Processes
- Operations Support
- Change Management Process
- Process Improvement
- Lead Support Skills
Affiliations
- Toastmasters
Timeline
IT Quality Control Analyst
Elevance
07.2014 - Current
Documentation Analyst Lead
Elevance
06.2013 - 06.2014
Operations Expert
Elevance
05.2010 - 06.2013
Claims Analyst II
Elevance
10.2008 - 05.2010
Provider Services Representative
Elevance
06.2007 - 10.2008
Technical Claims Specialist
Coventry
01.2005 - 01.2007
Medical Review Analyst
Concentra Integrated Services
01.2002 - 01.2004
Pharmacy Bill Reviewer
Pharmerica
01.2001 - 01.2002
Automated Logistics Specialist
United States Army
01.1997 - 01.2001
Bachelor of Science - Cyber Security
Saint Leo University
Associate of Arts - Liberal Arts
Saint Leo University
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