Over 9 years of overall QA experience and SQL.

EMEKO JONES

Chicago IL ● 602-***-**** ● **********@*****.***

SUMMARY

Confident, energetic, motivational problem solver with exemplary communication and organization skills; identifying challenges and develops solutions with exceptional accomplishments in process improvement per Six Sigma Lean methodology targeted to increase systems performance and profitability while maintaining working relationships with Business and IT stakeholders.

PROFESSIONAL EXPERIENCE

Valence Health 05/16 – 10/16

Quality Assurance Analyst Chicago IL

Conducted Agile regression testing, facilitated product evaluations to ensure client’s speciation met and documented error tracking via JIRA

Created / tested claims transactions via Selenium

Conducted analysis via SQL measuring performance, quality of care and services.

UnitedHealth Group 01/14 – 09/15

SR Tech Bus Analyst - Production Support Work from Home

Resolved member issues via root cause analysis, interviews, triage & data analysis

Extracted / interrogated data from various UHG data bases for critical issue resolution

Streamlines Sales Force errors drastically reducing issue resolution SLA and on-boarding

Interrogated IVR data for member call validation.

UnitedHealth Group 04/08 – 01/14

IT Quality Consultant - EDI Support Team Lead Work from Home

Resolved electronic claims submission (EDI) errors via SQL queries to ensure accurate adjudication, credentialing, contractual agreements / Fee schedule set-up and Provider payments

Created statistical reports, Pivot tables & graphs using data extracted from Access dbase, Diamond, Facets and TriZetto reflecting quality of care

Developed / administered EDI 101 training to Providers and Advocates increasing claims payments, eliminate billing errors ensure physician / hospital NPI / TIN loaded correctly and ensure payment accuracy

Maintained product backlog, ensured prioritization, resolution and implementation of defects and enhancements identified via issue resolution

Updated client Implementation materials after release of enhancements and capabilities

Conducted annual plan compliance audits to ensure state regulatory conformance.

EMEKO JONES

Chicago IL ● 602-***-**** ● **********@*****.***

Prudential Financial 08/06 – 04/08

Relocation Counselor Scottsdale AZ

Conducted root cause analysis via interviews, client documentation review, brain storming sessions, workflow analysis, observations, business process procedure overviews and statistical / matrixes to create automated solutions and process innovations to enhance products, services, procedures, and systems processing methodologies.

1ST National Bank of Arizona 04/05 – 05/06

MERS Administrator II (Mortgage Electronic Registration System) Phoenix AZ

Conducted workflow analysis to facilitate mortgage loan registration process automation, consolidation, decentralization and resolved home loan data validation issues

Maintained Mortgage Ware and PowerSeller applications data; conducted Empower loan processing conversion training to eliminate errors.

Claims Administration Corp (CAC) / CNA Insurance / First Health (FH) 06/00 – 02/03

Technical Analyst II Chicago IL

Maintained application reliability, insured HIPPA compliance, data integrity and provided 24/7 support for Web based claims inquiry application

Modified automated scheduler via UNIX scripts and DSTR processing to facilitate uninterrupted systems availability

Facilitated vendor selection, product evaluation, demonstrations, contract negotiations and procurement

Technical consultant on EDI vendor requirements, organizational structure, schedules, procedures, resource management, issues resolution, functional specifications, test requirements, file transfers methodologies and project evaluation for new and existing clients

Established technical solutions to insure regulatory compliance while meeting business needs; served as liaison between the user groups and technical teams

Analyzed and evaluated server configuration and operational procedures with developers to enhance server processing efficiency.

EDUCATION

Yellow Belt

SIX SIGMA - UHG

BA: Information Technology

OTTAWA UNIVERSITY

Certifications: LAN & Telecommunications

DE PAUL UNIVERSITY

Contact this candidate