Quality Assurance Medical
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CANDIDATE ID: 2876533
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TELEPHONE: 212-***-****
EMAIL: *******@*********.***
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HOTTEST SKILLS: health, claim, database, microsoft, systems analyst, healthcare, managed
care, medical, patient, reconcile, revenue
REVISION: 08-SEP-02
RESUME:
NAME: PETER CHENG
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PETER CHENG
46 DELANCEY STREET APT 4A NEW YORK, NY 10002
*******@*********.***
Profile: Designed systems in Microsoft Access and generated various
departmental reports. Intensive research and meeting dead lines on
statutory reports and projects. Knowledge of MS Office products,
Decision Analyzer, and Windows environments.
PROFESSIONALEXPERIENCE
Managed Healthcare Systems of New York, Inc
. March,1996 to presentSYSTEMS ANALYST
Designed a system in MS Access to run Managed Care Quality Assurance
Reporting Requirements (QARR) for New York State Department of Health.
Generates reports included Memberships, Utilization, and Well Care
Child Visits. Task in massive download from mainframe and
understanding hospital codes; codes includes CPT-4 Procedures, ICD-9,
Revenue Codes as well as internal codes. Built a system to run
quarterly Physician Profile report in MS Access for our Primary Care
Physician. Task includes incisive research of the claims and full
understanding of the companys database files. Generate and analyze
monthly dental reports. Reports includes graphs and charts on total
paid claims. Designed and generate system to reconcile monthly
Medicaid remittance report for our accountants to run their month end
closing report. Tasks included downloading data from tape and
importing data to MS Access for analysis in MS Excel. Analysis on
Diagnosis Related Grouping (DRG). Using Decision Analyzer, download
data and importing it into MS Access and MS Excel to produce reports
based on hospital and Service Intensity Weights (SIW) rates according
to patients long term stay or short term stay for our major providers
includes Woodhull Hospital, Jamaica Hospital, Brooklyn Caledonian, and
Flushing Hospital Medical Center.
EDUCATION
Stony Brook University
September 1991 to December 1995 Stony Brook, NY
DEGREE: Bachelor of Science,
December 1995 MAJOR: MATHEMATICS INTERN:
Education Opportunity Programs (EOP): paid tutor for pre-calculus and
calculus courses. ACTIVITIES: Enrolled in mathematics teaching program
where I spent 2 days a week in selected high schools to tutor students
in mathematics. Also, assisted teachers in writing lesson plans and
grade class exams.
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