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Customer Service Medical

Location:
Safety Harbor, FL
Posted:
October 23, 2015

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Resume:

Laurie Reece

acr6t5@r.postjobfree.com

770-***-****

PROFESSIONAL SUMMARY

An Experienced Analyst in ensuring business requirements were addressed in technology solutions for property and casualty insurance, healthcare insurance and medical center organizations to the complete satisfaction of clients.

Capable of handling multiple assignments concurrently, fast paced and the ability to work under pressure.

Over 15 years of experience in Customer Service/Sales

Assisted clients with analyzing and documenting Business Requirements.

Exercise initiative, achievement and independent judgment.

Assertive, self-motivated, goal-oriented, organized and efficient.

Demonstrated performance in accuracy, attention to detail and ability to work well in a team.

Strong technical aptitude, analytical, excellent communication skills, and learns automated tools quickly and skillfully.

Strong organizational and time management skills.

Client Management.

Medical and Insurance terminology.

HIPPA certified, EMR and EHR.

TECHNICAL COMPETENCIES

HP Quality Center

2010 SharePoint

Excel

Power Point

MS Office Suite/Projects

QA

HL7

Cloverleaf

SAS Module

PROFESSIONAL EXPERIENCE

KForce 8/2015 – present (Contract)

McKesson

Cloverleaf Interface Analyst

Editing and enhancing mapping of client’s ICD- 9 to ICD-10 diagnosis codes using HL7 interfaces

Optum 360 – 1/2014 – 8/2015

HL7 Technical Business Analyst

Responsible for client’s implementation of product including research, documentation, functional specifications and enhancements.

Communicating with and discerning the business needs of the client.

Troubleshooting daily issues that impact client’s usage of product.

Identify and document business process re-engineering opportunities including current and future state process flows.

Work with business users, systems analysts, and engineers to create, analyze, and verify required project documentation and customer system configurations.

The Experient Group

QBE First – 7/2012 – 4/2013

Business Analyst

Collaborate with business and technology departments to define deliverables and develop solutions that are reusable across the organization.

Map SDLC deliverables and project deliverables for easier access on SharePoint

Assisted other Business Analysts with Bank of America in locating and providing TSA Program BRDs/HLDs/LLDs associated with each application totaling over 90 mainframe and LINIX/LINUX/Wintel

Application.Requirements gathering to support BRD documentation.

Coordinating SDLC and audit SDLC documentation.

Participate in QA and User Acceptance Testing by writing test scripts, executing test cases and documenting defects.

Work with business users, systems analysts, and engineers to create, analyze, and verify required project documentation and customer system configurations.

Identify UAT scenarios, define UAT test plans, create UAT test cases, document the results in HP Quality Center.

Execute test cases within a SAS environment and manage defects

Proficient in AM, McKesson, HPF, EMR.

Icoma Consulting

Blue Cross Blue Shield Michigan - 6/2011 – 6/2012

Business Analyst

Provide assistance to projects impacting NASCO Claims.

Involved in testing, training and implementation of applications.

Working independently within guidelines, formulates and defines system scope and objective based on user needs and thorough understanding of business processes.

Requirements gathering to support BRD documentation for McKesson Claimsxten product.

Manage deployments of new product releases.

Identify UAT scenarios, define UAT test plans, create UAT test cases, and document the results.

Work with business users, systems analysts, and engineers to create, analyze, and verify required project documentation and customer system configurations.

Manage defects.

Participate in production level implementation testing to validate system quality.

Proficient in McKesson HPF, EMR.

Client Management.

Gwinnett Medical Center - 1/2009 - 11/2009

Medical Records Analyst

Prepare Medical Records reports for patients, doctors, clients and attorneys following HIPAA guidelines.

Insurance and GHP verification.

Provide records assistance to doctors and clients.

Coordinate and prioritize doctors, clients and attorney’s issues relating to HIPAA compliance and rules.

Proficient in AM, McKesson, Emstaff, PPL, BEM, HPF, EMR, HER.

Patient registration, verify insurance eligibility, indexing and scheduling.

Capture, index and retrieve patient information through the hospital’s electronic information systems, for the health information management (HIM) department and physicians.

Independent Consultant - 5/2008 – 12/2008

Intelistaff Healthcare - 9/2003 - 4/2008

Project Manager/Business Analyst

Take requests for services and convert into filled orders.

Coordinate health care staff to effectively meet client’s needs and ensured staff maintained HIPAA compliance and rules, EMR, HER, HPF.

Coordinate and process after hours calls.

Recruit professional health care applicants, HR duties.

Demonstrated performance in timely and responsive effective customer service.

Data mapping into Excel.

Liaison between business and technical teams to keep work flowing and on schedule.

Client Management.

Prior Experience before August 2003

Healthcare Coordinator/Claims Specialist at Talent Source: 4/2002 – 4/2004

Healthcare Coordinator at ASAP Healthcare: 4/2001 – 4/2004

Patient Access/L&D and ER Admissions at Northside Medical Center: 6/1998 – 5/2001

Education

Graduated High School – June 1984



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