Nancy Newell
North Grosvenor Dale,CT
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude and over 30 years administrative experience. Willingness to take on added responsibilities to meet team goals. Hardworking and passionate job seeker with strong organizational skills. Ready to help team achieve company goals. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
20
20
years of professional experience
Work History
Contract Configuration Analyst
Fallon Health
08.2010 - 11.2022
- Kept CM work aligned with project's configuration management plan.
- Implemented change control, configuration status accounting and configuration audits.
- Supported configuration department and government teams during COVID mandated changes, updates, system implementations with accurate, timely information on infrastructure system and service configuration items.
- Communicated and explained business requirements to team members to understand and implement functional demands.
- Applied knowledge of application components in conjunction with query tools to achieve business objectives.
- Carried out day-day-day duties accurately and efficiently.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Performed duties in accordance with applicable standards, policies and regulatory guidelines.
- Offered input for complex contract documents to support system-ready final versions.
- Self-motivated, with strong sense of personal responsibility.
- Worked effectively in fast-paced environments
- Managed time efficiently in order to complete all tasks within deadlines.
- Internal system utilization's examples as follows:
- Burgess (Medicaid reimbursement algorithm)
- Qnxt/QCS(Healthcare information system by TriZetto (now part of Cognizant) used to manage administrative, and financial operations.)
- Evips (Credentialing and compliance software for Healthcare Organizations.)
- Word Perfect and Excell
Provider Data Specialist
Fallon Community Health Care
05.2006 - 07.2010
- Received and processed contract and provider data requirements and implemented system requirements, deliverables and associated documentation.
- Sole trainer and point person for team education on protocols and IDX system functionalities.
- Trained team members in proper IDX data entry and contract execution within many available electronic tools and platforms.
- Collaborated with multi-functional roles to communicate and align development efforts.
- Tested software QNXT applications and systems to identify enhancement opportunities.
Claims Adjustment Specialist
Fallon Community Health Care
04.2003 - 04.2006
- Examined claims forms and other records to determine insurance coverage and benefit eligibility.
- Maintained claims data in IDX systems.
- Analyzed information gathered and made appropriate adjustment's to claims payments following member coverage and claims protocols.
- Collaborated with claims department and industry anti-fraud organizations to resolve claims.
- Reported to management on claims issues and backlog maintenance.
Education
Certificate - Medical Office Assistance
The Career Center
Worcester, MA05.1995
High School Diploma -
Burncoat Senior High School
Worcester, MA06.1989
Skills
- Systems Thinking
- Configuration Review
- Data Configuration
- Training Junior Team Members
- Test Plan Creation
- Team Support
- Contractual Compliance
- Manual Testing
Timeline
Contract Configuration Analyst
Fallon Health
08.2010 - 11.2022
Provider Data Specialist
Fallon Community Health Care
05.2006 - 07.2010
Claims Adjustment Specialist
Fallon Community Health Care
04.2003 - 04.2006
Certificate - Medical Office Assistance
The Career Center
High School Diploma -
Burncoat Senior High School
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