Taquicia Bailey
Virginia Beach,Virginia
Summary
Results-driven Business Analyst with extensive experience specializing in stakeholder management. Successfully led initiatives yielding over $3 million in savings and recoveries, demonstrating strong analytical thinking and problem-solving abilities. Known for enhancing business processes and promoting collaborative team environments.
Overview
18
18
years of professional experience
Work History
Business Analyst Sr.- Benefit Configuration
Elevance Health/Wipro
, VA
09.2021 - Current
- Mentored junior team members through peer reviews.
- Develop requirement change documents for benefit adjustments and explanations.
- Coordinated efforts between Health Plans and benefit configuration processes.
- Handled and replied to complex questions.
- Include all required elements within BRDs and their corresponding Facets summaries.
- Utilized understanding of system functionality to address defects.
- Assessed and examined regulatory compliance documentation.
- Supports organizational goals by delivering expertise in assigned product markets.
- Collaborated with business stakeholders and state intermediaries to capture evolving requirements.
- Managed projects and served as primary liaison between client and multiple internal groups to clarify goals and meet standards and deadlines.
- Worked closely with clients, technicians, and managerial staff to provide operational support and project updates.
Sr. Business Info Analyst - Program Integrity
Anthem Healthcare
, VA
08.2017 - 09.2021
- Implemented strategies for generating prepay leads, achieving over a million dollars in cost avoidance.
- Converted business requirements into practical decision-support tools.
- Examined official state portals and manuals to generate thorough prepay concept records.
- Participated in document analysis to ensure CMS guideline compliance.
- Identified project issues and provided resolutions to correct or stop excess spending and leakage.
- Mentored and supervised less experienced colleagues.
- Collaborated in cross-functional discussions to identify and implement best practices for initiatives.
- Assessed company operations for compliance with safety standards.
Business Analyst II -Financial Operations
Anthem Healthcare
, VA
08.2015 - 08.2017
- Facilitated effective communication between business teams and IT stakeholders.
- Conducted detailed evaluations of business needs, driving recovery of over $2 million in overpayments.
- Researched and authenticated fees using established state schedules.
- Verified claim accuracy for member eligibility, system coding and pricing, pre-authorization, and medical necessity.
- Detected over 60 payment discrepancies and potential medical expense risks by analyzing claim anomalies, outliers, and behaviors.
- Maintained library of model documents, templates or other reusable knowledge assets.
Sr. Business Analyst -Claim Intent Management
Anthem Healthcare
, VA
05.2014 - 08.2015
- Directed specialized project leveraging expertise in the field.
- Enhanced efficiency by revising claim instruction workflows.
- Optimized claim processing through development of targeted employee training materials.
- Analyzed processing inaccuracies, pinpointed areas needing quality advancements.
- Guided over 20 successful research initiatives for targeted project teams and client meetings.
- Compiled data insights and recommendations into succinct claim instructions.
- Created and revised processing instructions.
- Communicated to identify and meet documentation needs.
- Researched industry standards and best practices related to technical documentation.
Sr. Policy Analyst-Reimbursement Policy
Amerigroup
, VA
05.2011 - 05.2014
- Managed stakeholder expectations during document gathering, and meeting facilitation.
- Assisted with RFP preparations, bid proposals, and new market implementations.
- Served as liaison to state intermediaries on reimbursement policies and issues.
- Facilitated biweekly meetings for cross-functional workgroups.
- Ensured all reimbursement policies adhered to national billing and reimbursement guidelines, industry standards, and state reimbursement regulations.
- Created internal and external reimbursement policies.
Sr. Regulatory Project Coordinator-Compliance
Amerigroup
, VA
05.2010 - 05.2011
- Reviewed and audited all market-specific regulatory files for accuracy before publishing policies.
- Generated weekly, quarterly, and ad hoc reports for senior management.
- Drafted, refined, and assessed Corporate, Legal, and Health Plan policies.
- Acted as liaison with Health Plans to fulfill all regulatory and contractual obligations.
- Handled and resolved diverse complaints across several health plans.
Information Analyst/Technical Writer-Call Center
Amerigroup
, VA
07.2007 - 05.2010
- Streamlined data accuracy in National Resource Grids through timely updates.
- Created a content strategy and scoped out requirements for new products and plans.
- Contributed to key phases of development redesign initiatives.
- Assisted in writing test scripts, creating job aids, and running test cases.
- Developed resolution processes and procedures for the National Call Center.
- Established effective communication channels between different departments within the organization.
Education
Bachelor of Business Administration - Healthcare Administration
Strayer University
Skills
- Agile/Scrum Methodology
- Facets
- Contract Auditing
- Medical Contract Review
- Claims Processing
- Lean Rapid Improvement Training
- Knowledge of Medicaid, Medicare, and commercial insurance
- Root Cause Identification
- Requirements Gathering
- Business process improvement
- Stakeholder management
- Gap analysis
- Analytical thinking
- Quality assurance
- User acceptance testing
- Operations management
- Technical writing
- Agile methodologies
- Market research
- Team collaboration
- Problem-solving
Technical Skills
- Facets
- Macess
- Familiarity with translating basic SQL criteria
- Access database
- Demonstrated ability to utilize Excel for data analysis
- Visio
- Jira
- InterAct
Timeline
Business Analyst Sr.- Benefit Configuration
Elevance Health/Wipro
09.2021 - Current
Sr. Business Info Analyst - Program Integrity
Anthem Healthcare
08.2017 - 09.2021
Business Analyst II -Financial Operations
Anthem Healthcare
08.2015 - 08.2017
Sr. Business Analyst -Claim Intent Management
Anthem Healthcare
05.2014 - 08.2015
Sr. Policy Analyst-Reimbursement Policy
Amerigroup
05.2011 - 05.2014
Sr. Regulatory Project Coordinator-Compliance
Amerigroup
05.2010 - 05.2011
Information Analyst/Technical Writer-Call Center
Amerigroup
07.2007 - 05.2010
Bachelor of Business Administration - Healthcare Administration
Strayer University
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