Stephanie Onyekwere
Testing And Quality Control Analyst
Douglasville,GA
Summary
Highly motivated Quality Analyst experienced in developing and executing manual and automated test cases. Highly proficient in medical/pharmacy claims adjudication and analysis, testing tools and platforms, and process improvements. .
Overview
7
7
years of professional experience
Work History
Quality Assurance Analyst- Remote
Abarca Health
05.2024 - Current
- Review and understand client specifications and benefit design builds utilizing the client's Implementation Requirements Form
- Build standard and custom batch claim files in Excel for clients in all lines of business and benefit design complexities
- Build and execute SQL queries to analyze large data sets
- Conduct manual regression and functional claims testing through Darwin
- Maximized efficiency by creating and leading process improvement initiatives
- Analyze and interpret test claims for adjudication results to ensure configuration accuracy and compliance
- Troubleshoot plan/benefit configuration related questions through claims testing
- Document all defects found during testing
- Perform root cause analysis and define preventative measures
- Report findings resulting from all analytical work, including but not limited to batch testing, benefit compares, and claims testing
- Document results and follow through resolutions within the department's tracking system
Testing and Quality Control Analyst- Remote
Elixir Solutions
10.2022 - 05.2024
- Review and understand client specifications and benefit design builds utilizing the client's Benefit Specification/Change Form, Pharmscreens, and Jira requests
- Build standard and custom batch claim files in Excel for clients in all lines of business and benefit design complexities
- Conduct automated regression and functional claims testing through Pharmscreens
- Analyze and interpret test claims for adjudication results to ensure configuration accuracy and compliance
- Perform benefit compare analysis between Pharmscreens and the client's benefit Specification/Change Form
- Run SQL queries to retrieve data for reporting purposes
- Serve as point of contact for other departments while troubleshooting plan/benefit configuration related questions through claims testing
- Document all defects found during testing
- Perform root cause analysis and define preventative measures
- Report findings resulting from all analytical work, including but not limited to batch testing, benefit compares, automated claims testing, and applicable inquiries
- Document results and follow through resolutions within the department's tracking system
Customer Data Operations Analyst- Remote
Elixir Solutions
09.2020 - 12.2022
- Perform operational activities to generate, reprocess, and upload HMS files to an FTP site
- Coordinate weekly NDC adds and bi-annual GPI changes
- Clarify adjudication research requests and provide solutions for issue resolution inquiries
- Analyze need for reprocessing, coordinate benefit updates and plan configurations with the Benefit Design Administration team, perform reprocessing
- Analyze the results of reprocessing and recommend appropriate action
- Design and generate system permission templates as requested and monitor permission templates for appropriate use
- Perform initial and mid-year user access reviews for internal and external users of Pharmscreens
- Assist with production file monitoring
- Review dashboards to ensure data integrity of outgoing/incoming files
- Perform claims research as requested, define configuration solutions
- Serve as point of contact for troubleshooting adjudication issues
- Identify, define, and implement process improvements
Claims Analyst
Greenway Health
08.2017 - 06.2020
- Submit medical insurance claims and resolve second-tier denials from payers for an assigned practice using EHR software, specializing in Medicare Part B, Medicaid, VA, commercial and Workers' Comp
- Prepare and analyze daily, weekly, and end of month reports with focus on identifying trends and instituting continuous quality improvement initiatives
- Lead weekly conference calls with practice managers regarding A/R, workflow, patient accounts, and insurance processes
- Contact various payers and utilize their web portals to stay current on medical billing guidelines
Education
High School Diploma -
Bremen High School
Bremen, GA 08.2007 - 2011.05
Bachelor of Science - Psychology
Arizona State University
Tempe, AZ 01.2018 - 2020.02
Skills
Advanced with Excel
Proficient with SQL
Microsoft Office
PBM
Testing and QA
Process Improvements
Ticketing and Project Management Tools
Documentation
Issue Resolution
Root Cause Analysis
Timeline
Quality Assurance Analyst- Remote
Abarca Health
05.2024 - Current
Testing and Quality Control Analyst- Remote
Elixir Solutions
10.2022 - 05.2024
Customer Data Operations Analyst- Remote
Elixir Solutions
09.2020 - 12.2022
Bachelor of Science - Psychology
Arizona State University
01.2018 - 2020.02
Claims Analyst
Greenway Health
08.2017 - 06.2020
High School Diploma -
Bremen High School
08.2007 - 2011.05
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