Manager Data
Resume:
Valrie Cole
Woodbridge, VA *****
Job Objective:
Support Analyst/Account manager position in the information field where I will utilize my computer knowledge, deductive reasoning, and interpersonal skills.
Summary of Qualifications
15 years healthcare operational experience.
8 years technical support experience.
5 years application training.
5 years data analysis.
Knowledge of claims review and analysis.
Work Experience
Anthem
September 2018 – Current
EDI Helpdesk Analyst
Strong and Proficient knowledge of all aspects or Electronic Data Interchange (EDI) including but not limited to the following transactions. (835, 837I and P, 270/271, 276/277, 278, 277CA, 864, 834 and 820 Customer service and phone educate skills
Excellent written communication skills.
Ability to manage multiple priorities in a given day.
Experienced telephone Service Desk agent Experienced with Live Chat interactions and support SQL and query creation Microsoft office Suite ( Word Excel, Access) Unix.
Northrup Grumman
April 2017 – July 2018
Data Processing Analyst
Learn and understand the MSSO business process and workflow as they pertain to subscriptions and invoicing;
Correctly process information related to new and renewed MedDRA subscriptions
Assist with managing the customer relationship management workflow to develop and maintain queries and reports related to customer information and financial data
Participate in customer and financial data reconciliation processes
Created workflows to update list item, retrieve workflow history and to retrieve, delete and restore versions of list items using SharePoint.
Correspond with external users about their MedDRA subscription status
Organize and handle large volume of subscription billing
Strong analytical skills
Able to prioritize demanding workloads to meet monthly deadlines each month
United Healthcare
2015 – December 2016
Senior Clinical Data Analyst
Utilized Hyperion and Teradata to analyze trends in ORU data. Created custom vendor reports.
Responsible for case/ticket management Saleforce.com
Extrapolating data by performing queries. Knowledge of Access, SQL, pivot tables.
Familiar with LOINC codes and lab result data
Able to work independently or part of a cross-functional team.
Managed weekly team meetings. Response for client issues.
Managed accounts after going live into production. Reviewed HL7 specifications.
Managed SharePoint to share vendor progress information internally.
Met 100% of milestones for SharePoint, Access and Excel deployments and data transfers.
Liaison between various cross-functional teams regarding all aspects of projects and departments
Created provider scorecards pulling data showing improvements in results and focused and assisted providers with issues needing improvement.
Surescripts – Arlington VA, 22202
July 2007 – March 2014
Senior Customer Support Analyst
Experience with EDI (T-Sets), HL7, and XML supporting transaction systems. Managing their transaction errors.
Familiar with insurance coverage and benefit eligibility transaction types to PBMs 270/270-A1
Familiar with transaction types 837,835 for processing claims and reimbursement.
Experience using a case-management solution/CRM (SalesForce.com).
Performed queries to analyze & translate functional specifications & change requests into technical specifications.
Performed analysis researching volume, error frequency, and specific medical data transmitted by assigned vendors.
Resolved minor computer end user issues.
Own dedicated client relationships.
Managed assigned case load.
Escalated unresolved issues to higher-level support in accordance with established policies and procedures.
Performed readiness testing to insure proper connectivity and set up has been established for deployment of go lives. (SDLC). (Allscripts, Epic, Meditech,
Troubleshoot basic PC hardware, and Microsoft software issues.
Assisted users with application problems. Resolved customer complaints and concerns with strong verbal and negation skills.
Displayed courtesy and strong interpersonal skills with all customer interactions.
Processed large volume of inbound and outbound technical support calls.
Managed outage and maintenance notifications to vendors connected on the network.
Trainer
Specialized in process and support protocol training. Delivered training sessions in class, on-site, and over the web to groups of customer personnel.
Excellent communication, presentation and writing skills.
Created and managed training workflow for newly certified vendors coming on board.
Trained end users how to utilize custom computer system (Admin Console). Created logins and set access levels.
Provided onsite training out of state.
Provided offsite training for remote vendors.
Experienced utilizing PowerPoint for
Trained new employees and explained protocols clearly and effectively.
Prince William Hospital/Perot Systems/Dell - Manassas, VA 20110
2004 - 2007
Accounts Recovery Specialist II
Specialized in Virginia Medicaid (State and Local Hospitalization, (SLH), Amerigroup, HealthKeepers Plus, Unicare, VA Premiere, Sentera, etc. etc.) billing and collections.
Specialized in Virginia Medicaid enrollment.
Specialized in Workers Compensation billing.
Produced monthly insurance and self-pay reports in order to collect money from responsible parties.
Work directly with medical providers to help facilitate the process of enrollment with insurance payors
Manage the credentialing process from start to finish including obtaining applications from the payors, completing applications, submitting applications, following up with the payors to ensure applications are being processed and obtaining contracts once the credentialing process is completed.
Properly maintain files on each medically licensed professional including (CV, certifications, licenses, malpractice files, hospital privileges, etc.)
Salary
Negotiable USD
Education
A.S.
General Studies
Northern Virginia Community College
2006
8333 Little River Turnpike
Annandale, VA 22003
B.S.
Information Systems
Strayer University
2020
13385 Minnieville Rd.
Woodbridge, VA
Certificates
2013
American Management Association
Essentials of Project Management for the Non-Project Manager
2013
American Management Association
Instructional Design for Trainers
2013
American Management Association
PowerPoint Unplugged
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