Customer Service Representative

Bella Persad

** ***** ****** 973-***-**** Mobile

Belleville, NJ 07109 ***********@*****.*** 973-***-**** Home

PROFILE: Experienced Business Analyst / Capabilities Analyst / Product Analyst and IT Lead

with strong systems analysis and operations skills. Strengths include:

• Solid understanding of business requirement gathering and business process flow

using Waterfall and Agile methodologies. Able to write clear business requirement

documents.

• Experience in software development life cycle, gap analysis, requirements

traceability.

• Excellent analytical and organizational skills, including multi tasking ability.

• Strong track record as a liaison between IT and business units.

• Proven abilities in data collection, problem solving, decision making, leadership,

communication and interpersonal skills. Experienced in collaborating with various

teams to meet project deadlines.

• Proficient in creating test cases and test scripts, working with team members to fix

errors, as well as user acceptance testing (UAT).

• Experience in a Project Management Organization and in managing IT and

Corporate Projects.

• Rated highly for accountability, customer focus, work ethic and team spirit.

PROFESSIONAL EXPERIENCE

HORIZON Blue Cross Blue Shield of NJ (BCBSNJ), Newark, NJ

Horizon Health Innovations (HHI), former subsidiary of Horizon BCBSNJ

Senior Business Analyst / Capabilities Analyst 2010 – 2014

Horizon Health Innovations – now integrated into parent company Horizon BCBSNJ – is

transforming NJ’s health care delivery system by collaborating with partners to launch programs

around new models of patient care and reimbursement, with the goal to ensure high quality

care, increased patient satisfaction and improved affordability.

This initiative developed pilot programs (now implemented) such as Patient Centered Medical

Home (PCMH), Accountable Care Organization and Episodes of Care.

• Liaison between business units and IT. Conferred with stakeholders to determine user needs

and translate them into business requirement documents (BRDs) / Technical Requirement

Documents (TRDs) for both Waterfall and Agile methodologies.

• Conducted or co facilitated JAD sessions with multi location teams and authored use cases

and use case diagrams.

• Conducted thorough analysis of system’s existing ETL work flows and proposed enhancement

to improve efficiency.

• Prepared data flow (DFDs) and sequence diagrams for current and future state. Created test

case scenario documentation and test cases; monitored output and quality of results. Conducted

User Acceptance Testing (UAT) and consulted with technical team.

• Reviewed and prioritized product roadmap items based on business need.

• Identified issues and performed root cause analysis to mitigate them.

• Performed post production check out; communicated release notes to stakeholders.

• Provided operational and production support to stakeholders.

• Analyzed daily and monthly reports and provided trending behavior to management.

• Suggested recommendations for integrating systems and business process optimization, by

eliminating inefficiencies and redundancies and reducing cycle time.

• Commended for leading a sound and cost effective approach to turn on Resource Center link

on HHI web application weeks ahead of schedule.

• Managed the PCMH projects for onboarding new PCMH Providers. Also, managed the

enrollment of new members associated to these providers; coordinated with stakeholders

(Clinical Innovations, IT and Informatics Teams) to ensure that timelines were strictly adhered to,

ensuring that these projects were implemented on time and on budget. This was done using

Excel spreadsheet.

HORIZON Blue Cross Blue Shield of NJ

IT Lead – Projects and Enhancements NASCO systems 2005 – 2010

• Created change system requests to initiate work orders and technical requirements

needed for system updates.

• Wrote customer service requests for business units, including GENO table updates,

reporting regions, history conversions, system enhancements, customized EOB messages.

• Served as Co IT Lead for the following:

Thomas Solomon Act initiative projects

Several high profile Enterprise projects

New Jersey Mandates projects

Radiology Vendor Delegation project

• Assisted Operations in resolving major systems issue.

Senior Implementation Analyst 1999 2005

• Implemented several major/large market accounts, labor and small groups.

• Designated the IT Lead in implementing history conversion process for history claims.

• Provided production support for groups implemented for first month after go live date.

• Mentored and trained several new employees.

Customer Service Representative 1995 1999

• Handled front line customer contact. Researched and determined the root cause of claims

issues. Collaborated with IT on resolving identified issues.

Claims Examiner 1992 1995

• Researched and adjudicated claims pended. Identified system related claims issues and

worked with IT to resolve them.

EDUCATION AND CERTIFICATION

B.S., Business Administration, Concentration in Management, ST. PETERS COLLEGE,

2009

Certified Six Sigma Green Belt, 2010

Skills include: Microsoft Office tools including MS Visio; Waterfall and Agile methodologies;

Clearquest, SharePoint. MS Project and MS Access. Extensive experience with NASCO

claims processing systems.

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