David Kalin
Bartow,FL
Summary
Results-driven Data Analyst with extensive experience at Excellus BlueCross BlueShield, specializing in data quality and analytics. Proven ability to enhance reporting tools and streamline processes, leveraging advanced Excel & Access skills and analytical thinking to identify trends and recommend actionable solutions. Recognized for leadership in team training and compliance with security audits.
Overview
20
20
years of professional experience
Work History
Data Analyst III
Excellus BlueCross BlueShield
05.2015 - Current
- Produce daily, weekly and monthly inventory and metrics reports using advanced Microsoft Office functions including Word, Excel and Access.
- Identify, analyze and interpret trends or patterns in complex data sets. Collaborate with business-unit leaders to identify and prioritize issues.
- Create various Excel documents to assist with pulling metrics data and presenting information to stakeholders for concise explanations of best placement for needed resources.
- Monthly KPI reporting for a variety of Healthcare products. Analyze data and work with business teams to identify root causes of problems and recommend corrective actions.
- Developed dashboard and reporting tools to track business performance metrics. Month-to-Month electronic transaction figures for all Healthcare products offered by the Health Plan based on total volumes and first pass rate percentage.
- Provide technical support for troubleshooting analytics and reporting issues.
- Generate ad-hoc reports to evaluate specific business requirements.
- Enhanced security ID setup and maintenance while overseeing multiple corporate front-end user systems. Develop and implement business procedures to be in compliance with year-end corporate audits.
- Daily conversion of 834 inbound files from NYSOH to import into internal Database updated in real-time table and used for reporting and front-end staff.
- Monitor activity between the NYS Exchange Marketplace and internal systems such as: Facets, Siebel, Cognos, Edifecs, PEGA.
- Data analysis for a variety of lines of business: Commercial Group, Child Health Plus, Medicaid, Medicare, Essential Plan, Individual Exchange.
- Data Modernization to provide internal and external clients a front-end solution.
- Requirements intake via a ServiceNow ticket system which may include: data pulls, requirement/criteria intake liaison between the business and IT and/or Robotics.
Operations Unit Coordinator I/II
Excellus BlueCross BlueShield
03.2013 - 05.2015
- Trained new team members by relaying information on company procedures and safety requirements.
- Coached team members in techniques necessary to complete job tasks.
- Adjusted inventory to meet different productivity levels and department needs. Control and monitor daily inventory levels of Enrollment, Outreach (outbound calls) and Reconciliation teams while providing frequent updates to management.
- Point person between the Health Plan and Department of Social Services, other Health Plans, and New York State for Child Health Plus.
- Worked with team to identify areas of improvement and devised solutions based on internal audit findings.
Enrollment Research Processor
Excellus BlueCross BlueShield
02.2012 - 03.2013
- Monitor daily transactions to confirm acceptance by New York State. Identify issues with transaction submissions to make corrections at the state level.
- Identify trends with pre-screened errors and communicating trends to staff. Follow-up as needed with desk level procedures (DLP) and visualizations to be imported to internal libraries.
- One-on-one coaching with enrollment staff to enhance individual performance to meet department goals and expectations.
- Oversee daily and weekly reports including: terminations, expired eligibility, New York State voucher comparison reports, demographic discrepancies.
- Conducted financial screening and documentation gathering for clients to determine qualification for payment programs
Enrollment Specialist
Excellus BlueCross BlueShield
03.2009 - 02.2012
- Review and process Child Health Plus and Healthy New York applications.
- Oversee daily, weekly and monthly reports for enrollment including treasury cash receipts, cancellation due to unpaid premiums, recertification, refunds and daily credit reports.
- Input and compare daily inventory volumes, compare data in Microsoft Excel, analyze inventory volumes and suggest recommendations to divide inventory assignments to maintain department metric standards.
- Carefully review applications and all applicable documentation to prove residency, income and eligibility for the product(s) offered.
Medical Records Examiner/Provider File Maintenance
StaffWorks Agency
10.2007 - 03.2009
- Maintained confidentiality of all medical records and sensitive information to comply with HIPAA regulations.
- Research Medical and Dental claims through internal operating system (LRSP).
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Update existing provider contacts and demographics for the transfer of information to the Facets system.
- Review and audit provider entries by staff and make updates as needed.
- Cleaned up files regularly by removing outdated information for archival or disposal.
Mail Processing Clerk
United States Postal Service
05.2005 - 09.2007
- Used automated mail processing equipment to sort and collate mail.
- Proved successful working within tight deadlines and a fast-paced environment.
- Loaded letters onto processing equipment, removed non-processable letters and maintained continuous sorting feed.
- Sorted and placed mail into mailboxes and post office boxes with high levels of accuracy.
- Oversee night shift supervisor to monitor production quality and accuracy to meet operational goals.
- Performed routine preventive maintenance on sorting machines and removed envelope jams.
- Utilized physical strength to move mail and packages of varying sizes and weights.
Education
Business Administration
SUNY College At Oswego
Oswego, NYHigh School Diploma -
Liverpool High School
Liverpool, NY06.2003
Skills
- Data Quality
- Data and Analytics
- Microsoft Office
- Enrollment Procedures
- Team Leadership
- Analytical Thinking
- Data Research and Validation
- Security Audit
- Database management
- Intake & Requirements
Coach Commissioner
Upward Sports Basketball: January 2022-March 2023.
Lead annual pre-season and summer camp coaches trainings.
Connect with coaches, parents, and athletes to provide the best possible sports experience.
Promoting the discovery of Jesus Christ through sports.
Observe weekly practices and games and follow-up with coaches if changes are needed to their approach or execution.
Timeline
Data Analyst III
Excellus BlueCross BlueShield
05.2015 - Current
Operations Unit Coordinator I/II
Excellus BlueCross BlueShield
03.2013 - 05.2015
Enrollment Research Processor
Excellus BlueCross BlueShield
02.2012 - 03.2013
Enrollment Specialist
Excellus BlueCross BlueShield
03.2009 - 02.2012
Medical Records Examiner/Provider File Maintenance
StaffWorks Agency
10.2007 - 03.2009
Mail Processing Clerk
United States Postal Service
05.2005 - 09.2007
Business Administration
SUNY College At Oswego
High School Diploma -
Liverpool High School
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