Daniel Lei
Happy Valley,OR
Summary
Business systems professional with strong analytical skills and results-driven mindset. Proven track record in optimizing system processes and enhancing operational efficiency. Adept at working collaboratively within diverse teams and adapting to dynamic environments. Skilled in data analysis, requirements gathering, and project management, ensuring reliable and impactful solutions.
Overview
10
10
years of professional experience
Work History
Business Systems Analyst
Cambia Health Solutions
Portland, OR
12.2025 - Current
- Analyzed business requirements to enhance system functionality and user experience.
- Analyzed business requirements and translated them into functional system specifications to support membership and enrollment processes.
- Supported ANSI 834 / EDI enrollment file processing, ensuring accurate eligibility and membership data exchange between systems.
- Performed system configuration, validation, and troubleshooting for membership and eligibility workflows.
- Executed unit testing, user acceptance testing (UAT), and regression testing for system updates, enhancements, and defect fixes.
- Wrote and executed SQL queries and ad hoc reports to analyze membership data and support operational decision making.
- Collaborated with technical teams and business stakeholders to clarify system requirements and resolve data or configuration issues.
- Conducted post implementation quality assurance to validate system changes and ensure accurate enrollment processing.
- Investigated and resolved system functionality inquiries and enrollment discrepancies impacting membership records.
- Documented functional requirements, testing procedures, and system configurations to support project delivery and operational transparency.
- Supported process improvement initiatives to increase efficiency and accuracy in membership and eligibility administration.
- Facilitated communication between business operations and technical development teams to ensure system solutions aligned with operational needs.
- Assisted in analyzing membership data, enrollment transactions, and eligibility updates to maintain compliance with internal and regulatory standards.
Membership Administrator
Cambia Health Solutions
03.2024 - 12.2025
- Utilize ANSI 834 enrollment files to verify eligibility data, identify discrepancies, and update member records in Facets, ensuring alignment with group coverage.
- Analyze group eligibility audits and enrollment file summaries to identify and resolve discrepancies affecting coverage accuracy and premium calculations.
- Reconcile large group membership records (100+ child groups) using Excel and root cause analysis to identify billing errors and eligibility misalignments.
- Collaborate with departments such as Business Support Services, Sales, and Customer Service to resolve complex data discrepancies and provide audit-ready documentation for group accounts.
- Draft and maintain procedural documentation in Microsoft Word for inclusion in the Knowledge Management Tool (KMT), supporting operational training and knowledge consistency.
- Respond to internal and external inquiries related to eligibility and enrollment within established SLA windows (24–72 hours), enhancing service delivery and cross-team communication.
- Conduct self-audits and submit supporting documentation through Radar, proactively identifying system issues and improving overall data quality control.
- Ensure HIPAA compliance and enforce data privacy protocols during all stages of eligibility processing and record handling.
- Verify premium rates and plan selections against documentation to support accurate invoicing and renewal processing.
Transportation Security Officer
Transportation Security Administration
01.2019 - 02.2022
- Conducted compliance audits of travel documentation/property and security protocols, documenting and escalating incidents to support internal reviews and regulatory reporting.
- Interpreted and applied evolving federal policies under strict operational requirements, exercising meticulous attention to detail and discretion when handling sensitive materials.
- Applied strong attention to detail and discretion while evaluating sensitive materials.
- Performed risk assessments of passengers and baggage against standardized criteria, honing the ability to evaluate and classify risk exposures.
Shift Lead
Red Robin
07.2016 - 08.2018
- Ensured product quality and operational consistency, including inventory management, sanitation, and compliance with food-safety and workplace standards.
- Enforced company policies and health codes by training, mentoring, and monitoring team members, fostering a culture of compliance and safety.
- Managed inventory forecasting and cost controls, analyzing usage trends to prevent waste.
- Maintained detailed incident and variance logs, ensuring transparent documentation for leadership reviews.
- Tracked and reported on key performance metrics (e.g., order accuracy, service times, customer satisfaction scores), then implemented corrective actions.
Education
Bachelor of Science - Business Economics
Portland State University
Portland, OR01-2026
Minor - Computer Science
Skills
ANSI 834 (EDI Enrollment File Format), Project Testing, Diagnostics, Coding Foundation (Primary: C, Secondary: Python, SQL), Health Data Systems (Facets, Radar, KMT), Eligibility Processing, Requirements Gathering & Documentation, Data Management, Reconciliation, Rate Verification, Auditing, Quality Assurance, Risk Assessment, Risk Management, Operational Compliance, Policy Adherence, Regulatory Environment Experience (HIPAA), Issue Resolution, Process Improvement, Problem Solving, Root Cause Analysis, Written & Verbal Communication, Project & Team Coordination, Time Management, Microsoft Suite (Excel, Outlook, Word, OneNote), Customer Service, Cross-functional Collaboration, Requirements gathering,
Timeline
Business Systems Analyst
Cambia Health Solutions
12.2025 - Current
Membership Administrator
Cambia Health Solutions
03.2024 - 12.2025
Transportation Security Officer
Transportation Security Administration
01.2019 - 02.2022
Shift Lead
Red Robin
07.2016 - 08.2018
Minor - Computer Science
Bachelor of Science - Business Economics
Portland State University