LAMAR J. BEGAY
Atlanta,GA
Summary
Result-oriented Senior Business Systems Analyst with over two decades of progressive experience in the healthcare Payer domain, strong background in healthcare claims and claims-based platforms, with deep expertise in medical claims processing/adjudication (Multi-State Medicare A, B, C, D & Medicaid), EOB, and SBC. Also, two decades of retail (warehouse management and supply chain) experience. I am skilled in gathering business requirements, translating them into detailed technical specifications, and collaborating with developers, testers, and vendors. Proficiency in data mapping is extensive, warehouse management and logistics with hands-on experience using tools like IBM Sterling Integrator to create and manage data maps for various EDI transactions (e.g., ANSI 835, 837, 850, 810, 812, 811). Adept at working with external vendors and partners to ensure seamless B2B integration. A proven team player, Lamar is proficient in multiple methodologies, including Agile (SAFe) and SDLC, and has a track record of supporting new programs and optimizing existing application stacks to achieve cost savings. Extensive experience with a wide range of systems, including Salesforce, Azure DevOps, Jira, ERP applications, TriZetto FACETS, Epic Tapestry, Amisys, and various EDI platforms including Sterling Integrator and Axway, makes him a valuable asset in fast-paced, complex environments.
Business professional with comprehensive background in analyzing complex data to drive strategic initiatives. Known for enhancing operational efficiency and supporting decision-making processes through detailed analysis. Highly collaborative team member focused on achieving results and adapting to dynamic business needs. Proficient in data modeling and process improvement.
Overview
22
22
years of professional experience
Work History
Business Analyst
Randstad / Kaiser Permanente
06.2025 - 08.2025
- Served as a primary liaison between customer communities, subject matter experts, and multiple agile software development teams.
- Led requirements-gathering sessions with stakeholders to define and elaborate on Epics, Features, and user stories for new healthcare and retail system implementations.
- Utilized SAP/FICO and SAGE to fix file issues (EDI orders, invoices, financials) using the IDOC or file number.
- Deployed complex mapping to transform data formats into standardized EDI X12 and EDIFACT. Monitored, troubleshot and processed errors of all transaction flows, onboarded new Trading Partners utilizing secure communication protocols (AS2, SFTP, FTP and HTTP/HTTPS. Managed B2Bi configurations and migrations.
- Created Healthcare Summary of Benefits and Coverage (SBC) documents for distribution to members.
- Documented detailed business requirements (BRDs) and acceptance criteria, ensuring clarity and accuracy for engineering, quality assurance, stakeholder teams and led EDI implementation projects from requirements gathering Trading Partner setup through AS2, ERP and Sterling Integrator (profile, EDI and messaging) and mapping.
- Facilitated agile ceremonies, managed JIRA boards (Scrum/Kanban), worked with agile teams on story card refinement, sprint planning, daily standups sprint review, sprint retrospective and backlog refinement/prioritization and performed backlog prioritization to drive product roadmap decisions.
- Managed the case management lifecycle for features and bugs, working with software engineers to analyze customer problems and relate them to product strategy.
- Spearheaded user acceptance testing (UAT) and production testing for multiple projects, validating system behavior and functionality prior to release.
- Contributed to SDLC process improvements by studying current practices and designing modifications, leading to more efficient software delivery.
- Collaborated with Quality Assurance to review test plans and ensure business requirements were accurately represented in test scenarios.
- Responsibilities
Business Integrations Analyst/Product Owner
PDS Aerospace & IT Services / US Foods
10.2024 - 04.2025
- Gathered technical specifications and Document requirements for new retail integrations using IBM Sterling Integrator and Azure DevOps.
- Created and monitored mapping configurations and connections, ensuring successful data interchange for supply chain and retail EDI.
- Assisting with AR/AP investigation (reviewing ledgers) and correction (SAP FICO)/SAGE.
- Performed pre-production (UAT) and production testing of file transmissions, managing the rollout of new and updated integrations.
- Provided analysis and clarification to development and Quality Assurance teams, resolving issues throughout the implementation lifecycle.
- Deployed complex mapping to transform data formats into standardized EDI X12 and EDIFACT. Monitored, troubleshot and processed errors of all transaction flows, onboarded new Trading Partners utilizing secure communication protocols (AS2, SFTP, FTP and HTTP/HTTPS. Managed B2Bi configurations (Sterling Integrator (IBM) and migrations.
- Worked with other Business Analyst and team to present an understanding of the new retail business requirements.
- Performed UAT/PROD test files and configurations for live file transmissions.
- Creation and retrigger of invoices when needed.
- Collaborated with the Quality Assurance team and developers to elaborate on Epics, Features, and user stories, card refinement and backlog prioritization.
- Gained understanding and behavior of new and existing retail and chain supply management systems and its integrated software as well as payment protocols.
- Develop detailed specifications for new systems and/or modifications to existing ones based on the requirements document created.
- Managed JIRA boards (Scrum Master) and reported status updates and worked with Agile teams on story card refinement, sprint planning, daily standups sprint review, sprint retrospective and backlog refinement/prioritization as well as creation of financial reports including Adhoc.
- Responsibilities
Business Analyst – Product Owner
Insight Global / Cigna Healthcare
06.2023 - 07.2024
- Reviewed and processed pre-authorizations for patient prescriptions and treatments, demonstrating deep domain knowledge in healthcare benefits.
- Assisting new clients and the team with Integration to the current SAP/FICO (S/4HANA).
- Ensured data format and processing adhered to HIPPA compliance standards, mitigating risk in FTP processes.
- Worked with 837 (P,D and I Ansi X-12 formatted files), 835, 834, 270/271, 820 and 278.
- Led EDI implementation projects from requirements gathering Trading Partner setup through AS2, ERP and Sterling Integrator (profile, EDI and messaging) and mapping.
- Collaborated on product documentation with support and training teams, preparing materials for customer-facing releases.
- Gathered requirements and technical specifications for new and existing implementations plans with Developers using AZURE Dev Ops.
- Performed UAT/PROD test files and configurations for live file transmissions with Quality Assurance team.
- Promoted and created new and existing business requirements specifications, backlogs refinement, changes expectation (acceptance criteria) are documented throughout lifecycle of the project.
- Planned, testing and validation of full system (application) increment.
- Reviewed and processed pre-authorizations from providers (payer and provider) for patient prescriptions and treatments including SBC and Explanation of benefits.
- Worked with other Business Analyst and Agile teams on story card refinement, sprint planning, daily standups sprint review, sprint retrospective and backlog refinement/prioritization.
- Implemented care management processes and assured correct data format for FTP processes per HIPPA Compliance.
- Responsibilities
Senior Business Analyst – Project Manager
LaSalle Network/Solera Healthcare
08.2023 - 12.2023
- Gathered requirements and technical specifications to create requirements documentation for new and existing implementations plans while creating EPIC user stories and performed analysis to assist with UAT and development (Azure dev Ops) activity.
- Proactively identified and managed risks by providing regular project updates on milestones and deadlines to ensure all targets met service level agreements (SLAs).
- Assisted with managing inventory using the Material Management modules. (MM, WMS, OMS ERP)
- Spearheaded design review and change control meetings by facilitating discussions and promoting business requirements and acceptance criteria changes throughout the project lifecycle.
- Directed a team of business analysts in executing tactical and strategic plans, fostering team performance and project success.
- Served as the primary liaison between customer communities, internal business teams, and the software development lifecycle (SDLC) teams, ensuring clear communication and alignment.
- Managed the end-to-end UAT process by creating mock-up EDI test files and conducting thorough testing across Dev, Stage, and UAT environments to ensure robust functionality prior to release.
- Deployed complex mapping to transform data formats into standardized EDI X12 and EDIFACT. Monitored, troubleshot and processed errors of all transaction flows, onboarded new Trading Partners utilizing secure communication protocols (AS2, SFTP, FTP and HTTP/HTTPS. Managed B2Bi configurations (IBM Sterling Integrator) and migrations.
- Collaborated with the Agile teams on story card refinement, sprint planning, daily standups sprint review, sprint retrospective and backlog refinement/prioritization.
- Worked with other Business Analyst and team to present an understanding of the new retail business requirements.
- Served as a point of contact/reference to the development and QA team for technical and functional testing clarifications.
- Promoted business requirements and creation of business requirement document and ensured updates, backlogs, changes expectation (acceptance criteria) are documented throughout lifecycle of the project with Agile team.
- Managed team performance and directed business analysts in executing tactical and strategic plans. Performed end-to-end testing of FACETS claim lifecycle: intake → validation → adjudication → remittance. Planned and conducted presentations for integration and implementation processes.
- Responsibilities
EDI Business Analyst / Project Manager / Product Owner / Scrum Master
Cognizant (Full-time)
12.2021 - 07.2023
- Promoted business requirements and creation of business requirements document, created implementation plans (SAFe/PIs) and ensured updates, backlogs, changes expectation (acceptance criteria) are documented throughout lifecycle of the project, Agile / (Dev Ops).
- Accountable for managing 28 market mappings for multiple healthcare, retail, and automotive projects, streamlining data analysis and client billing processes.
- Utilized the (SD) Sales and Distribution module to assist with sales and shipping aspects and billing.
- Authored clear and detailed business requirements documents, implementation plans (SAFe/PIs), and feature/user story definitions that drove backlog prioritization and team collaboration.
- Worked with 837 (P,D and I Ansi X-12 formatted files), 835, 834, 270/271, 820, 278, 810, 850.
- Deployed complex mapping to transform data formats into standardized EDI X12 and EDIFACT. Monitored, troubleshot and processed errors of all transaction flows, onboarded new Trading Partners utilizing secure communication protocols (AS2, SFTP, FTP and HTTP/HTTPS. Managed B2Bi configurations (IBM Sterling Integrator) and migrations.
- Coordinated cross-functional teams of developers and QA to validate logic and successfully implement new features and applications.
- Managed the end-to-end implementation of multiple healthcare payer and provider portfolios, overseeing claim processing and data exchange.
- Created feature and bug cases within the case management system and collaborated with software engineers to analyze customer problems and define solutions on the product roadmap.
- Retrieved WMS and inventory data from customers and uploaded it into SAP (FICO)- JDE E1/SAGE ERP systems using the Visual Integration tool, ensuring accurate and timely data management.
- Performed daily/weekly reports to provide project understanding to team members of milestones, timelines and updates on all assigned projects targets are on track and meeting SLA/delivery date.
- Created Epics, Features and user stories, and gathered requirements for various applications to collaborate with the scrum/Agile teams on story card refinement, sprint planning, daily standups sprint review, sprint retrospective and backlog refinement/prioritization.
- Coordinated with QA and developers to validate maps and logic.
- Successfully steered and managed multiple healthcare payer and provider portfolio for a client-based operation including EOB, SBC, Claim processing.
- Responsibilities
Integrations EDI Business Analyst / Project Manager / UAT Testing
Fortitude / MedeAnalytics
04.2021 - 11.2021
- Managed implementation of new features and coordinated cross-functional teams.
- Managed the implementation of new features by collaborating with cross-functional teams and ensuring seamless integration.
- Wrote and managed detailed specification requirements for new customer systems and modifications to existing ones.
- Proficiently performed Agile updates using Kanban and documented user story refinement and backlog progression.
- Supported the Quality Assurance team by reviewing test plans, ensuring test cases addressed all business requirements.
- Utilized Excel/SAS vs Legacy to compare, create and interpret data reports.
- Created detailed specifications requirements for new customer systems or modifications to existing.
- Assisted with Treatment plan with home nurse care, EOB, Claims processing and SBC information.
- Monitored incoming and outgoing EDI files (xml/Ansi) for payer and provider claims via EDI Gateway (IBM Sterling Integrator).
- Worked with 837 (P,D and I Ansi X-12 formatted files), 835, 834, 270/271, 820, 278, 810 and 850.
- Proficiently performed updates with Agile team on story card refinement, sprint planning, daily standups sprint review, sprint retrospective and backlog refinement/prioritization to update Kanban, QA, documentation, portfolio, story card refinement and backlog.
- Responsibilities
EDI Business Analyst / Project Manager
Talent Navigator, Icon Industrial Solutions / Halstead International
01.2020 - 05.2020
- Effectively facilitated communication between customers, stakeholders, and supporting departments, ensuring seamless collaboration and information flow while organizing third-party logistics (3PL) operations, enhancing efficiency and reliability.
- Facilitated communication between customers, stakeholders, and internal departments, leading to seamless collaboration and information flow for third-party logistics (3PL) operations.
- Successfully managed all testing, implementations, and upgrades with customers and Value-Added Networks (VANs), minimizing disruptions.
- Analyzed and designed technical specifications for enhancements and extensions in various retail EDI applications and interfaces, including ERP and WMS systems, Accellos/Tcys, and SPS Commerce/Fulfillment applications. Worked with retail EDI transactions 810, 850 and 856.
- Deployed complex mapping to transform data formats into standardized EDI X12 and EDIFACT. Monitored, troubleshot and processed errors of all transaction flows, onboarded new Trading Partners utilizing secure communication protocols (AS2, SFTP, FTP and HTTP/HTTPS. Managed B2Bi configurations (IBM Sterling Integrator) and migrations.
- Took ownership of the business functionality delivered by the QA and Development teams, ensuring high-quality and on-time releases.
- Collaborated with the Agile teams on story card refinement, sprint planning, daily standups sprint review, sprint retrospective and backlog refinement/prioritization.
- Worked with other Business Analyst and team to present an understanding of the new retail business requirements.
- Analyzed and designed technical specifications for enhancements and extensions in EDI applications and interfaces, including ERP Sage/Mapadocs -JDE E1, SaaS, Store POS systems, WMS Accellos/Tcys, and SPS Commerce/Fulfillment applications.
- Successfully managed all testing, implementations, and upgrades with customers and value-added networks (VANs), ensuring smooth transitions and minimal disruptions.
- Responsibilities
EDI Business Analyst
Apex Systems / Advantasure
04.2019 - 10.2019
- Supported qualitative testing and interpreting messages received, offering suggested updates to improve existing protocols and enhance overall system performance.
- Performed daily/weekly reports to provide project understanding to team members of milestones, timelines and updates on all assigned projects targets are on track and meeting SLA/delivery date.
- Monitored and corrected incoming/outgoing file transfers.
- Worked in Scrum/Agile teams on story card refinement, sprint planning, daily standups sprint review, sprint retrospective and backlog refinement/prioritization and gathered technical specifications and requirements.
- Promoted business requirements and creation of business requirements document and ensured updates, changes expectation (acceptance criteria) are documented throughout lifecycle of the project.
- Tested client data files and implemented care management forms for clients within the payer and provider space for claims processing, assisting employees with EOB and SBC information.
- Managed product backlog and created use cases and test case scenarios (Agile).
- Performs UAT Data File Testing to ensure successful user experience and product integrity.
- Responsibilities
EDI Business Analyst / Product Owner
The Judge Group/Anthem
08.2018 - 03.2019
- Supervised and corrected healthcare provider and payer healthcare files utilizing Gateway and Guiding Care application.
- Collaborated with all organizational levels to support accurate data exchanges and effective data management within the company.
- Assisted employees with information such as EOB, SBC, Claims processing details (Payer).
- Promoted business requirements and creation of business requirements document and lead Agile teams on story card refinement, sprint planning, daily standups sprint review, sprint retrospective and backlog refinement/prioritization.
- Performed daily/weekly reports to provide project understanding to Agile team members of milestones, timelines and updates on all assigned projects targets are on track and meeting SLA/delivery date.
- Implemented care management processes and assisted with medical supply inventory control.
- Responsibilities
EDI Business Analyst
Loyal Staffing/Halyard Health
07.2017 - 10.2017
- Utilized in-house order management tools to address order errors, entries, and inventory control issues, maintaining accuracy and efficiency.
- Utilized in-house order management tools to address order errors and inventory control issues, maintaining accuracy and efficiency.
- Optimized supply chain systems by monitoring and editing stock levels and inventory replenishment data for retail and warehouse management operations (JDE E1).
- Processed order-to-cash healthcare payment claims and managed inventory restock scheduling.
- Monitored and edited supply chain systems to address quantity on hand and inventory replenishment issues, optimizing retail, logistics, and warehouse management operations - JDE E1.
- Crosschecked, validated, and edited healthcare and retail EDI transactions.
- Led EDI implementation projects from requirements gathering Trading Partner setup through AS2, ERP and Sterling Integrator (profile, EDI and messaging) and mapping.
- Processed order to cash healthcare payment claims and performed WMS inventory restock scheduling.
- Managed and updated data for inventory and utilized WMS to ensure order deliveries.
- Responsibilities
EDI Business Analyst
Arrow Strategies/Blue Care Network
04.2017 - 07.2017
- Monitored and analyzed data exchanges with partners, identifying and correcting errors to maintain data integrity and reliability.
- Utilized Excel/SAS to create and interpret data reports.
- Gathered technical specifications and functional requirements, which led to successful modifications that met all project timelines.
- Monitored and analyzed data exchanges with partners, identifying and correcting errors to maintain data integrity and reliability.
- Created and interpreted data reports using Excel/SAS to provide analytical support for decision-making.
- Assisted in implementing care management processes and produced high-quality applications by capturing and testing functional requirements.
- Gathered technical specifications and requirements and tested client data while implementing care management processes and provided analytical support.
- Captured and tested all modifications to proposed functional requirements meeting all project timelines and deadlines.
- Assisted clients and team in producing high-quality applications.
- Responsibilities
EDI Business Analyst
Infotree / Eaton Corporation - Retail Domain
08.2016 - 09.2016
- Performed customer invoice validations within ERP systems/WMS application to ensure accurate pricing and billing, reducing discrepancies and improving financial accuracy.
- Conducted thorough analysis of supply chain workflows, providing timely solutions for issues and vulnerabilities.
- Performed customer invoice validations within ERP systems SAP FICO/SAGE, which reduced discrepancies and improved financial accuracy.
- Led EDI implementation projects from requirements gathering Trading Partner setup through AS2, ERP and Sterling Integrator (profile, EDI and messaging) and mapping.
- Collaborated with development teams to elaborate on Epics, Features, and user stories during sprint planning and refinement.
- Participated in client intake calls for project clarifications.
- Collaborated with the Agile teams on story card refinement, sprint planning, daily standups sprint review, sprint retrospective and backlog refinement/prioritization.
- Conducted thorough analysis and provided timely solutions for supply chain workflows, while swiftly resolving issues, and vulnerabilities.
- Managed and edited data transactions and performed order management.
- Extracted and compared complex data groups while gathering technical specifications and requirements.
- Responsibilities
Lead EDI Business Analyst/Project Manager
Mizuno USA – Full-time
12.2015 - 04.2016
- Created, edited, and corrected errors in order/inventory transactions, reflecting customer orders and associated transaction sets for trading partners.
- Led production support for existing Retail EDI Trading Partners, ensuring successful supply chain operations (WMS) by monitoring inventory and trading partner data.
- Deployed complex mapping to transform data formats into standardized EDI X12 and EDIFACT. Monitored, troubleshot and processed errors of all transaction flows, onboarded new Trading Partners utilizing secure communication protocols (AS2, SFTP, FTP and HTTP/HTTPS. Managed B2Bi configurations (IBM Sterling Integrator) and migrations.
- Ensured the successful delivery of releases by collaborating with the development team and validating deliverables before they went live into production.
- Created presentations and financial forecasts for Trading Partners, demonstrating expertise beyond standard technical analysis.
- Corrected errors in order/inventory transactions for trading partners, maintaining data accuracy and workflow efficiency.
- Participated in client intake calls for project clarifications.
- Collaborated with the Agile teams on story card refinement, sprint planning, daily standups sprint review, sprint retrospective and backlog refinement/prioritization.
- Worked with other Business Analyst and team to present an understanding of the new retail business requirements.
- Validated release deliverables before go live into production.
- Entrusted to ensure the successful outcomes of supply Chain Operations SAP( FICO) / (JDE E1) while monitoring inventory and trading partner data, performing routine analysis to assure quality performance.
- Created presentations and financial forecasts for Mizuno USA’s Trading Partner via ecommerce.
- Responsibilities
Technical Analyst
TekSystems/Cricket Communications
04.2015 - 07.2015
- Installed software, modified and repaired hardware, and resolved technical issues.
- Assisted with network issues and application issues for Cricket stores.
- Responsibilities
Senior EDI Business Analyst
Modis/Home Depot
09.2014 - 10.2014
- Acted as the Liaison and main point of contact between the business and data partners, developing guidelines and specifications for data exchanges, and ensuring compliance and accuracy.
- Served as the main point of contact between the business and data partners, developing guidelines and specifications for data exchanges.
- Ensured compliance and accuracy of data by collaborating with development teams to elaborate on Epics, Features, and user stories.
- Managed backlog prioritization to effectively communicate and deliver new retail business requirements.
- Collaborated with the Agile teams on story card refinement, sprint planning, daily standups sprint review, sprint retrospective and backlog refinement/prioritization.
- Worked with other Business Analyst and team to present an understanding of the new retail business requirements.
- Promoted business requirements and creation of business requirements document and ensured updates, changes expectation (acceptance criteria) are documented throughout lifecycle of the project.
- Utilized E-Commerce and WMS to ensure special order deliveries.
- Responsibilities
Technical Business Consultant
Insight Global/Mercy Health
08.2014 - 09.2014
- Assisted with project migration and created implementation plans for McKesson and pharmacy software.
- Trained pharmacy employees on new applications and identified business processes.
- Responsibilities
Technical Support Specialist II
American Telephone and Telegraph Corporation (AT&T)
04.2014 - 07.2014
- Migrated Dell PCs from Windows XP to 7 and assisted with ELO software issues.
- Assisted with network issues and driver installations.
- Responsibilities
Technical Support Specialist II
Amerit Consulting / McKesson
03.2013 - 01.2014
- Repaired database errors and assisted pharmacies with software applications pharmacy operations.
- Used SQL scripts to maintain and fix errors within applications.
- Responsibilities
Implementation EDI Business Analyst, Medicaid Project Implementation
Hewlett Packard
09.2011 - 06.2012
- Assisted Medicaid Providers by email and telephone with conversion implementation from 4010 to 5010 EDI for 837 UB04 files.
- Created use cases and test case scenarios (file mock-ups), process flows and provider data validation.
- Assisted Medicaid providers with the conversion from 4010 to 5010 EDI for 837 UB04 files via email and telephone, ensuring a smooth transition.
- Created detailed specifications and use cases/test case scenarios (including mock-ups) for new customer applications, validating processes and data.
- Configured healthcare data in Facets to create Health Rules, demonstrating specific technical knowledge in this domain.
- Implemented care management processes and ensured correct file formatting for FTP transfers, aligning with EDI file guidelines.
- Configured healthcare data retrieved from client comparing to data within facets to create Health Rules.
- Implemented care management processes based on facilities guidelines during the creation of implementation plans and processes to assure correct format for ftp processes to align with EDI file guidelines (payer and provider) to that medical files come through gateway correctly.
- Created detailed documentation specifications requirements for new customer applications or modifications to existing.
- Collaborated with the Agile teams on story card refinement, sprint planning, daily standups sprint review, sprint retrospective and backlog refinement/prioritization.
- Responsibilities
Business Analyst
Kelly Services / Multiple Clients (Automotive, Healthcare, Retail)
04.2003 - 06.2006
- Utilized JDE (Distribution and WMS) and the creation of financial reports using Cognos for implementation plans of services logistical integrations.
- Spearheaded logistical integrations by utilizing JDE and creating financial reports with Cognos to inform implementation plans.
- Performed UAT testing to ensure system functionality, including successful barcode printing and file transfers (FTP/PO 850) for automotive plants.
- Optimized supply chain management for automotive parts by planning, executing, monitoring, and controlling all aspects of procurement (PO/850) and shipping (856).
- Managed order fulfillment and ensured on-time deliveries by utilizing WMS (JDE) for picking and packaging processes.
- Used Unix shell and SQL scripts to manage databases and system configurations for various applications.
- Handled provider pre-authorizations for patient treatments, reviewing and processing data to ensure accuracy before determination.
- Promoted business requirements and creation of clear detailed business requirements document and ensured updates, changes expectation (acceptance criteria) are documented throughout lifecycle of the project.
- Performed UAT testing to assure automotive plants can successfully print shipment barcodes from network and sent PO (850) via File Transfer Protocol (FTP).
- Utilizing WMS (JDE) to ensure orders are picked and packaged as well as on time deliveries (order management).
- Performed Billing (ISU) for metered gas and electrical usage. (DTE Energy)
- Reviewed and processed (multi-client) pre-authorizations from Providers for patient Rx’s/Medical treatments (specialty) to assure data is correct before handing off for determination (approval or denial).
- Collaborated with the development team to elaborate on Epics, Features, and user stories, card refinement and backlog prioritization.
- Utilized SI and Gentran to extract EDI Docs from edifacts electronic data interchanges following processing.
- Unix shell used on both versions) to manage the database such as users, file storage, any configuration performed/system configurations, application clusters, and SQL scripts.
- Responsibilities
Education
GED -
Michigan Board of Education (State)
Skills
- Healthcare & Claims Expertise: With over 20 years in the healthcare domain, expert in Medical Claims Processing/Adjudication for Medicare (A, B, C, D) and Medicaid, knowledge extends to Eligibility, EOB, and SBC, along with claims auditing and HIPAA Compliance He is highly proficient in healthcare-specific EDI, including ANSI X-12 transaction sets (835, 837)
- Technical & Systems Proficiency: Technical background is extensive, with experience spanning over 15 years in Oracle E-Business and SAP (FICO) modules (SD, MM, IM), SDJ and JDE, and over 5 years in JIRA Well-versed in a wide range of claims-based platforms such as TriZetto FACETS, QNXT management, Epic Tapestry, Amisys, and MMIS, chain supply (WMS, ERP and OMS modules), IBM/Sterling Integrator, Gentran, B2B integration skills include using tools like IBM Sterling Integrator, and proficient in data mapping, SFTP/FTP, AS2, Web Services, and HL7
- Methodology & Project Management: A seasoned professional, 5 years of experience in Project Management and a strong grasp of both Agile and SDLC methodologies Proficient in SAFe/PIs, JIRA, and Confluence, and has proven experience in managing projects, facilitating B2B integrations, and leading teams
- Requirements gathering
- Agile methodology
- User acceptance testing
- Stakeholder management
- Process mapping
Previous BCBS clients
- Blue Care Network
- Anthem: BCBS of Michigan, Alabama, New York, Georgia, California and Connecticut.
- Solera health: BCBS of New Hampshire, Ohio, Wisconsin Colorado and Virgina
- Cognizant: Alabama, New York, Georgia, California and Connecticut, New York, Georgia and California
Previous Business and Financial Clients
- Home Depot
- Bank of America System
- Anthem: State of Michigan, Alabama, New York, Georgia, California, Ohio, New Hampshire, Virgina and Connecticut.
Timeline
Business Analyst
Randstad / Kaiser Permanente
06.2025 - 08.2025
Business Integrations Analyst/Product Owner
PDS Aerospace & IT Services / US Foods
10.2024 - 04.2025
Senior Business Analyst – Project Manager
LaSalle Network/Solera Healthcare
08.2023 - 12.2023
Business Analyst – Product Owner
Insight Global / Cigna Healthcare
06.2023 - 07.2024
EDI Business Analyst / Project Manager / Product Owner / Scrum Master
Cognizant (Full-time)
12.2021 - 07.2023
Integrations EDI Business Analyst / Project Manager / UAT Testing
Fortitude / MedeAnalytics
04.2021 - 11.2021
EDI Business Analyst / Project Manager
Talent Navigator, Icon Industrial Solutions / Halstead International
01.2020 - 05.2020
EDI Business Analyst
Apex Systems / Advantasure
04.2019 - 10.2019
EDI Business Analyst / Product Owner
The Judge Group/Anthem
08.2018 - 03.2019
EDI Business Analyst
Loyal Staffing/Halyard Health
07.2017 - 10.2017
EDI Business Analyst
Arrow Strategies/Blue Care Network
04.2017 - 07.2017
EDI Business Analyst
Infotree / Eaton Corporation - Retail Domain
08.2016 - 09.2016
Lead EDI Business Analyst/Project Manager
Mizuno USA – Full-time
12.2015 - 04.2016
Technical Analyst
TekSystems/Cricket Communications
04.2015 - 07.2015
Senior EDI Business Analyst
Modis/Home Depot
09.2014 - 10.2014
Technical Business Consultant
Insight Global/Mercy Health
08.2014 - 09.2014
Technical Support Specialist II
American Telephone and Telegraph Corporation (AT&T)
04.2014 - 07.2014
Technical Support Specialist II
Amerit Consulting / McKesson
03.2013 - 01.2014
Implementation EDI Business Analyst, Medicaid Project Implementation
Hewlett Packard
09.2011 - 06.2012
Business Analyst
Kelly Services / Multiple Clients (Automotive, Healthcare, Retail)
04.2003 - 06.2006
GED -
Michigan Board of Education (State)