Customer Service Product Development

Wendy M. Wahl

518-***-**** **** Colgate Place, Schenectady, NY 12304 **********@*****.***

Benefit Analyst

I am a polished and articulate professional with a strong background and understanding in healthcare. A tenacious work ethic combined with unmatched organizational and people skills allows me to open and sustain effective communication with all levels of associates and management. I am a goal-oriented achiever who takes pride in accomplishing projects beyond expectation.

KEY STRENGTHS

EDI

X12 Configuration

270 / 271 Transactions

Implementation Coordination

Group Migration

Project Liason

Customer Service

EDI Training

Product Training

Claims Training

New Business Coordination

Renewal Coordination

Member Portal Research

Provider Portal Research

Minor EDI Coding

Minor X12 Coding

EDUCATION

Cosmetology Degree and License

J.W.H. Cosmetology

Plattsburgh, NY 1992

Business Studies Degree

Beekmantown High School

Beekmantown, NY 1992

ADDITIONAL SKILLS

Leadership, Analytical,

Communication, Interpersonal,

Responsible, Strong

Background in Healthcare

(PPO, EPO, HMO, PRISM,

Matrix) Minor Programming,

Clear Quest, Vendor Relations,

Creative workflows and Standard

Process.

PROFESSIONAL PROFILE

Business Analyst

MVP 2015-2017

Used Facets NetworX for facility configuration, rate sheet creation, and distribution to operations

Analyzed First Pass error pends and provided presentations on solutions for First Pass Gain

Analyzed and tested procedure and code in a SCRUM environment while translating business policy methods to system developers

Mastered TFS tracking for SCRUM agile environment Benefit Analyst

Anthem Blue Cross Blue Shield 2010-2015

Acquired and assigned to train an offshore team of eight to audit new and renewal group implementation. Currently handling new product development across six platforms.

Analyze to identify and define problems including root cause and scope

Conduct meetings defined by specific problems

Identify fastest and most cost productive solutions

Fix problem if it can be handled by myself or my team

Conduct desired results meetings and offer solutions if handed to another department

Extensive knowledge in CS90 developed in claims background

Full working knowledge of healthcare offered today including PPO, EPO, HMO, CDHP, Prism, Matrix, Indemnity, Hospital only, Medical Supplement, HRA, HSA, and MediBlue

Projects:

EBA project team

Lead analyst for SSCR 20071 Medicare Supplement

Lead Analyst for Live Health Online

Lead Analyst for New Prism EPO Select Product

QA Plasm New Business, Renewal, Blues Exchange

Claims Examiner

Anthem Blue Cross Blue Shield 2007-2010

Entry level position in which I quickly developed an understanding of coding on claims. In a short time I was promoted to a position of training. Trained new hires and used for high priority accounts.

Lead examiner for new account sign on

Managed team workflow and system solutions

Assured compliance of medical policy and payment guidelines

Continually exceeded quality and quantity expectations for medical claim reports

Responsible for high priority accounts

Trainer (New Hire)

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