Tammy Miles Watkins
Kathleen,GA
Summary
Seasoned Senior Business Analyst with expertise in technology analysis and process improvement at Elevance Health. Skilled in using analytical tools and Agile methods to boost efficiency. Strong SQL skills and a commitment to mentoring team members. Aims to lead initiatives that enhance organizational success.
Overview
26
26
years of professional experience
Work History
Senior Business Analyst
Wipro
Remote
08.2024 - 02.2025
- Designs and builds standard and non-standard benefit plans, analyzes business rules to identify the best approach to code and develop benefits in the benefit configuration database to achieve optimum claims adjudication levels.
- Improvements that enhance productivity, minimize errors, and increase task completion rates by 20%, ensuring projects are consistently delivered ahead of schedule.
- Performs testing and quality assurance of new products developed to avoid negative financial, regulatory, and operational impacts.
- Resolve system configuration defects based on knowledge and analysis of system functionality in conjunction with the benefit plans.
- Managed sensitive patient information with strict adherence to HIPAA guidelines, maintaining confidentiality and privacy at all times.
- Review state contracts, fee schedules.
- Code coverage review.
- Lead the on boarding process for new employees.
- Mentored junior analysts on best practices for business analysis techniques, fostering professional growth within the team.
- Managed stakeholder expectations through transparent communication and timely status updates, ensuring alignment between project deliverables and business objectives.
- Automated routine tasks significantly boost team productivity and focus.
Business Analyst III
Elevance Health
Remote
09.2021 - 07.2024
- Designs and builds standard and non-standard benefit plans, analyzes business rules to identify the best approach to code and develop benefits in the benefit configuration database to achieve optimum claims adjudication levels.
- Performs testing and quality assurance of new products developed to avoid negative financial, regulatory, and operational impacts.
- Resolve system configuration defects based on knowledge and analysis of system functionality in conjunction with the benefit plans.
- Researches and responds to complex inquiries from various departments
- Review state contracts, fee schedules.
- Code coverage review
- Manage conflicting priorities and multiple projects concurrently.
- Actively participated in team meetings to share knowledge, exchange ideas, address challenges, and collaborate on potential solutions.
- Developed high-quality documentation to support training efforts, helping employees fully understand new systems and procedures.
- Drove operational efficiency by automating routine tasks, freeing up staff to focus on more complex issues.
- Led testing and quality assurance initiatives to mitigate financial and operational risks.
Claims Operations Expert
Elevance Health
Remote
10.2015 - 09.2021
- Good understanding of the application of benefit contracts, pricing, processing, policies, procedures, government regulations, coordination of benefits, and healthcare terminology.
- Good working knowledge of claims and products, including the grievance and/or reconsideration process, and authorization.
- Excellent knowledge of the various operations of the organization, products, and services.
- Reviews, analyzes, and processes claims and policies related to events to determine the extent of the company's liability.
- Researches and analyzes claims issues.
- Responds to inquiries, and may involve customer or client contact.
- Provide training, and lead onboarding.
- Assist with questions from associates in many forms.
- Collaborated with cross-functional teams to improve overall claims management processes.
- Interpret policies and procedures for accuracy.
- Participate in and contribute to special projects as assigned.
- Evaluated complex claim scenarios, applying critical thinking skills to ensure fair resolutions for all parties involved.
- Automated routine tasks significantly boost team productivity and focus.
- Developed comprehensive documentation to streamline employee training processes.
Patient Care Coordinator
Sentara Healthcare
Norfolk, VA
05.1999 - 10.2015
- Organized Cardiac Procedures.
- Organized intervention radiology procedures.
- Optimize the document, improving document accessibility by 15%.
- Managed sensitive patient information with strict adherence to HIPAA guidelines, maintaining confidentiality and privacy at all times.
- Trained new staff members on office procedures and protocols, ensuring consistency in patient care delivery.
- Communicated with insurance companies to verify coverage and obtain authorizations for medical treatments and procedures.
- Provided exceptional customer service by addressing concerns, answering questions, and ensuring patient satisfaction with their care experience at the clinic.
- Facilitated communication between patients and medical staff to ensure seamless care coordination.
Education
Bachelor of Science - Health Administration/Management
University of Phoenix
Phoenix, AZ10-2014
Skills
- Technology architecture analysis
- Forecasting and planning
- Business administration
- Analytical tool implementation
- Operations analysis
- Agile methodology
- KPI tracking
- Requirements gathering
- Business process improvement
- SQL proficiency
- Data analysis
- Process development
- Leadership in technology projects
- Cross-functional collaboration
- Stakeholder Management
References
References available upon request.
Timeline
Senior Business Analyst
Wipro
08.2024 - 02.2025
Business Analyst III
Elevance Health
09.2021 - 07.2024
Claims Operations Expert
Elevance Health
10.2015 - 09.2021
Patient Care Coordinator
Sentara Healthcare
05.1999 - 10.2015
Bachelor of Science - Health Administration/Management
University of Phoenix
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