Tammy Miles-Watkins
Kathleen,GA
Summary
Seeking a challenging position in business industry where I can utilize my experience to contribute to the success of the company.
Equipped with strong problem-solving abilities, willingness to learn, and excellent communication skills. Poised to contribute to team success and achieve positive results. Ready to tackle new challenges and advance organizational objectives with dedication and enthusiasm.
Overview
26
26
years of professional experience
Work History
Senior Business Analyst
Wipro
08.2024 - Current
- Designs and builds benefit standard and non-standard benefit plans, analyzes business rules to identify best approach to code/develop benefits in the benefit configuration database to achieve optimum claims adjudication levels
- Performs testing and quality assurance of new product developed to avoid negative financial, regulatory, and operational impact
- Resolve system configuration defects based on knowledge and analysis of system functionality in conjunction to the benefit plans
- Researches and responds to complex inquiries from various departments
- May consult, mentor peers to attain department goals
- Perform all duties as directed by management
- Review state contracts/ Fee Schedules
- Code coverage review
Business Analyst III
Elevance Health
09.2021 - 07.2024
- Designs and builds benefit standard and non-standard benefit plans, analyzes business rules to identify best approach to code/develop benefits in the benefit configuration database to achieve optimum claims adjudication levels
- Performs testing and quality assurance of new product developed to avoid negative financial, regulatory, and operational impact
- Resolve system configuration defects based on knowledge and analysis of system functionality in conjunction to the benefit plans
- Researches and responds to complex inquiries from various departments
- May consult, mentor peers to attain department goals
- Perform all duties as directed by management
- Review state contracts/ Fee Schedules
- Code coverage review
Operations Expert
Elevance Health
10.2015 - 09.2021
- Good understanding of the application of benefit contracts, pricing, processing, policies, procedures, government regulations, coordination of benefits, & healthcare terminology
- Good working knowledge of claims and products, including the grievance and/or re-consideration process
- Excellent knowledge of the various operations of the organization, products, and services
- Reviews, analyzes, and processes claims/policies related to events to determine extent of company's liability
- Researches and analyzes claims issues
- Responds to inquiries, may involve customer/client contact
- Provide operational training
- Assist with questions from associates in many forms
- Interpret policies and procedures for accuracy
- Participate and contribute to special projects as assigned
- Ability to multitask, while attaining accuracy with tight deadlines
Patient Scheduler
Sentara Healthcare
05.1999 - 10.2015
- Scheduled Cardiac Procedures
- Scheduled Interventional Radiology Procedures
- Electronic Patient Records
- Verify insurance
- Coordinated Inter Facility Ambulance
- Liaison between patients and medical staff
- Provide operational training
Front End Customer Service Manager
K-Mart Store
10.2006 - 04.2011
- Implemented new processes for returns and exchanges, simplifying the process for both employees and customers.
- Assisted in the hiring, training, and onboarding of new front-end staff members to ensure a high level of customer service was maintained.
- Maintained a clean, organized workspace to create a welcoming environment for customers.
- Boosted employee morale and productivity with effective communication, team-building activities, and recognition programs.
- Manage store budgets, control expenses, and analyze financial reports to optimize profitability.
- Ensure compliance with company policies, procedures, and health and safety regulations to maintain a safe shopping environment.
- Lead, mentor, and motivate a team of up to 20 retail associates to achieve sales targets and provide exceptional customer service.
Education
Bachelor of Science - Health Administration/Management
University of Phoneix
Phoneix, az01.2014
Skills
- Facets
- Microsoft Office
- Process development
- Material requirements planning
- InterAct
- Customer Service
- Facility coordinating
- Jira
- Purchasing and planning
- EPIC System
- Logistics management
- Requirements gathering
- Scheduling and planning
Timeline
Senior Business Analyst
Wipro
08.2024 - Current
Business Analyst III
Elevance Health
09.2021 - 07.2024
Operations Expert
Elevance Health
10.2015 - 09.2021
Front End Customer Service Manager
K-Mart Store
10.2006 - 04.2011
Patient Scheduler
Sentara Healthcare
05.1999 - 10.2015
Bachelor of Science - Health Administration/Management
University of Phoneix
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