Kristen Konesky
Northford,CT
Summary
Remote Business Analyst with over 23 years of experience in a Fortune 500 healthcare organization, specializing in data integrity, process optimization, and user acceptance testing. Proven ability to enhance cross-functional collaboration and align IT solutions with strategic business goals. Recognized for delivering impactful outcomes through effective analysis and implementation of business strategies.
Overview
24
24
years of professional experience
1
1
Certification
Work History
Business Analyst III, CarelonRx
Elevance Health, Inc
Wallingford, CT
01.2021 - Current
- Evaluates business processes to uncover areas for optimization and efficiency.
- Utilizes comprehensive testing protocols, identifying and resolving 99% of critical bugs prior to deployment.
- Organizes discussions with stakeholders, focusing on project status, and mitigating challenges throughout the project lifecycle.
- Evaluates project deliverables to confirm alignment with business objectives.
- Oversees project timelines by tracking milestones, deliverables, and tasks.
- Creates detailed test plans and test cases based on software requirements, effective in validating system functionality.
- Applies Agile methodology to foster flexibility across the project lifecycle, works alongside various departments to obtain required approvals, and prioritizes customer satisfaction.
- Amends obsolete workflows and establishes clear standard operating procedures (SOPs) to enhance process consistency.
- Performs comprehensive root cause analysis to uncover underlying issues, or inefficiencies.
- Identifies and mitigates project risks through proactive Agile practices, resulting in the reduction of project delays and issues.
- Works alongside cross-functional teams to acquire data and insights, addressing identified problems.
- Provides recommendations for corrective and preventive action plans based on findings.
- Supported the evaluation and rollout of a productivity-enhancing software automation tool.
- Led the onboarding and training of offshore resources, providing continuous support while overcoming language barriers to ensure seamless integration.
- Sole onshore contributor responsible for driving multiple high-impact projects and minor system improvements simultaneously, with successful delivery.
IT Quality Assurance Analyst, Sr.
Wellpoint, Inc.
North Haven, CT
01.2005 - 02.2020
- Handled project changes from inception to implementation.
- Executed a successful deployment of changes into production, serving as the lead for the Northeast (CT, ME, NH).
- Served as primary contact for benefits, sales, enrollment, and management to facilitate service delivery.
- Addressed stakeholder inquiries regarding services provided in a timely manner.
- Facilitated workshops to elicit functional and non-functional requirements.
- Preserved comprehensive records of requirements and processes for auditing.
- Evaluated available testing resources, analyzed budget constraints, and determined optimal testing effort level for project, assigning tasks and responsibilities among team members to align workload with individual capabilities and capacity.
- Reviewed system designs to ensure that the proposed solution meets customer needs.
- Translated technical requirements into a Functional Business Requirements document to develop user stories, use cases, workflow diagrams, and related resources.
- Executed functional, regression, system integration, smoke, and user acceptance testing.
- Monitored post-production processes to assess challenges stemming from newly applied modifications.
- Compiled data from multiple sources for use in presentations or reports.
- Nurtured and maintained strong connections with internal and external stakeholders.
- Cultivated a team-oriented environment to enhance organizational performance through knowledge-sharing initiatives between departments.
Medical Claims Processor and Auditor
Anthem Blue Cross Blue Shield
North Haven, CT
05.2001 - 01.2005
- Processed a high volume of claims on a daily basis, using established time frames and exceeding productivity benchmarks with high accuracy.
- Supported efficient handling of complex claims and followed up on open, denied, or suspended claims to complete required line items.
- Processed claims using electronic health record systems efficiently.
- Based payment or denials of medical claims upon well-established criteria for claims processing.
- Determined liability, compensability, and benefits due on each claim by interpreting insurance policies to determine coverage on submitted claims.
- Lead monthly audit sessions with team members to review productivity and outline recommendations for process improvements.
- Conducted training sessions for staff on audit procedures and compliance standards.
- Evaluated and communicated patterns of claims to identify improper billing and claim errors.
- Investigated discrepancies in medical billing information such as incorrect codes or amounts due.
- Verified accuracy of provider data entered into the system including tax ID numbers, NPI numbers, address changes .
- Stayed current on HIPAA regulations, benefits claims processing, medical terminology and other procedures.
- Ensured compliance with insurance company policies and procedures related to the processing of claims.
- Identified potential fraud cases based on analysis of submitted claims data and escalated accordingly.
- Performed Quality Assurance checks on processed claims ensuring all edits were resolved prior to submitting them for adjudication and payment.
Education
High School Diploma -
North Branford High School
North Branford, CTEarly Childhood Education
Eastern Connecticut State University
Willimantic, CTPsychology
University of Massachusetts, Lowell
Lowell, MASkills
- Data analysis and reporting
- Stakeholder management
- Business process optimization
- Agile, Waterfall, Software Development Lifecycle
- Jira
- Microsoft Teams
- UAT planning and execution
- Adaptability
- Workflow documentation
- Cross-functional collaboration
- Communication
Certification
- Lean Six Sigma Yellow Belt Certification (in progress)
- Lean Six Sigma White Belt • Analysis Certificate Program (2025)
- AGILE project planning (2025)
- Aspiring Leader Certificate Program (2024)
- Business Analyst Certification • University of Colorado Denver (2005)
Accomplishments
- Associate Recognition Impact Award - 2023
- Associate Recognition Impact Award - 2024
References
References available upon request.
Timeline
Business Analyst III, CarelonRx
Elevance Health, Inc
01.2021 - Current
IT Quality Assurance Analyst, Sr.
Wellpoint, Inc.
01.2005 - 02.2020
Medical Claims Processor and Auditor
Anthem Blue Cross Blue Shield
05.2001 - 01.2005
High School Diploma -
North Branford High School
Early Childhood Education
Eastern Connecticut State University
Psychology
University of Massachusetts, Lowell
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