JOHN S SPOLL

**** ***** ****** ****** ******** TX 79118 (806) 223 – 6731 ac0zq5@r.postjobfree.com

SUMMARY:

Accomplished Business Analyst and Operations Manager skilled in operational efficiency and increasing revenue in the healthcare and insurance industries. Business process improvement, data analysis and specifications expert. Employs root cause analytics to identify issues and develops process improvement and implementation capabilities. Master of exceeding expectations and meeting project timelines. Ability to translate English into Development terminology leverages database objects and infrastructures.

EXPERIENCE:

SENIOR BUSINESS SYSTEMS ANALYST CONDUENT AMARILLO, TX 06/13/2011 – 05/17/2013 and 08/02/2013 – 06/09/2017

For this client- facing position as the primary Business Systems Analyst assigned to write technical specification for the StrataWare Bill Review Engine (BRE); leveraged root cause analytics to identify issues and develops process improvement and implementation capabilities. Incorporated the User experience due to ability to manually reprice workers’ compensation medical bills.

ACCCOMPLISHMENTS:

With a very aggressive project plan timeline for three specific Functional Specification Documents to be completed; I recognized their relationship, combined them into one document and bested the sign off timeline by over two months.

Ran multiple client facing Joint Application Development (JAD) and Joint Application Requirements (JAR) sessions collecting and translating client requirements into internal understanding documents as to be able to be programmed and tested for eventual implementation.

OPERATIONS MANAGER STRATACARE AMARILLO, TX 05/18/2012 – 08/01/2013

Reporting to the Vice President of Operations, position was over the day – to – day operation of a multi – million dollar workers’ compensation medical bill review processing center for the world’s largest workers’ compensation third – party administrator (TPA).

ACCCOMPLISHMENTS:

Hired and trained all personnel within a very aggressive timeline as to be able to process 100,000 workers' compensation medical bills per month following client - specific manual while maintaining accuracy and turnaround expectations.

Hired and trained staff for the associated call center meeting the clients' service level agreement protocols for the number of calls handled per day.

SENIOR BUSINESS ANALYST MITCHELL INTERNATIONAL AMARILLO, TX (TELECOMMUTE) 04/04/2009 – 06/10/2011

For this internal - facing position as the primary Business Systems Analyst assigned to write technical specification for the Smart Advisor Bill Review Engine (BRE); leveraged root cause analytics to identify issues and develops process improvement and implementation capabilities. Incorporated the User experience due to ability to manually reprice automobile liability medical bills.

JOHN S SPOLL

6313 South Bonham Street Amarillo TX 79118 (806) 223 – 6731 ac0zq5@r.postjobfree.com

ACCCOMPLISHMENTS:

Wrote technical specifications incorporating a Diagnostic Rate Group (DRG) grouper into their suite of products allowing clients to more accurately reprice their inpatient hospital bills.

Reviewed revised or new medical fee schedules and wrote the corresponding logic to have this all automated within Smart Advisor BRE product saving clients’ money.

SENIOR BUSINESS SYSTEMS ANALYST TEXERT INCORPORATED 11/01/2007 – 03/30/2009

For this international client- facing position as the primary Business Analyst assigned to write technical specification and user guides for the Governance Risk Bill Review Engine (BRE); leveraged root cause analytics to identify issues and develops process improvement and implementation capabilities.

ACCCOMPLISHMENTS:

Wrote technical specifications and user guides for a "Loss Event" product that measured client risk exposure based upon the clients pre-determine comport level of risk.

Ran cross – functional team meetings with colleagues located in the United States, China, Scotland, England and South Africa.

SENIOR BUSINESS ANALYST/PROJECT MANAGER CS STARS 10/03/2000 – 10/28/2007

For this client- facing position as the primary Business Systems Analyst assigned to write technical specification for the Claim Suite Bill Review Engine (BRE); leveraged root cause analytics to identify issues and develops process improvement and implementation capabilities. Incorporated the User experience due to ability to manually reprice workers’ compensation medical bills. Managed third - party vendor data and implementation (e.g. ICD – 9, DRG Grouper, Patterns of Treatment (Utilization Review Product) and Code Review).

ACCCOMPLISHMENTS:

Co-authored a three-year code move up calendar which met all service level agreements (SLA)

Transferred written specifications from word format to Visio shortening both development and quality assurance time lines while maintaining code impact analysis

EDUCATION:

BS IN BUSINESS ADMINISTRATION MAJORING IN ECONOMICS AND FINANCE BARNEY SCHOOL OF BUSINESS 05/23/1982

SKILLS:

Functional Specifications Documentation and resulting software enhancements and defect resolution

CRM Queue management and Software Delivery Life Cycle (SDLC) – RUP, Agile, Waterfall

Medical repricing: CPT, ICD, ASC, DRG (State – driven and Medicare – driven models)

Subject Matter Expert (SME) in workers’ compensation, medical auto liability, preferred provider organization (PPO) and managed care.

TFS/JIRA/PDS/CRM/UAT

REFERENCES AVAILABLE UPON REQUEST:

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