Customer Service Microsoft Office

DANIEL GRAY

**** ****** ******* ******, *** ****, Marietta, GA 30064

****.********@*****.*** 850-***-****

RESULTS-DRIVEN ANALYST & DOCUMENTATION SPECIALIST

Improve processes and customer understanding by communicating challenges in easy to understand language Analytical professional who uses a background in mathematics to identify relevant issues in an efficient and thorough manner. Leverage personally developed acting and writing skills to deliver solutions in an easily digestable manner, reducing client and customer frustration and allowing for process improvement. Proven expertise in process improvement, client relations, documentation and problem analysis. Almost 10 years in private and public sector Healthcare IT, with skills adaptable to multiple environments. Areas of expertise include:

ANSI X12 standards Mathematics

Customer Service Microsoft Office

Data Analysis Public Speaking

Documentation Maintenance Technical Writing

HIPAA rules and regulations Training

Work Experience

EDI ANALYST & VENDOR MANAGEMENT – Greenway Health (Atlanta, GA) 2015 - 2016

Led effort to assure that company brand identity and demographic information was consistent across a client base of 300+ public and private medical insurance payers.

Performed daily transmission and maintenance of incoming and outgoing medical claim files from over 200 transmission partners.

Monitored and maintained open issue queue to assure resolution of cases within a timeframe 8% better than normal SLA metrics.

GOVERNMENT ANALYST I I – Agency for Healthcare Administration (Tallahassee, FL) 2014 - 2015

Led effort to educate managed care organizations on the electronic submission rules of Florida's Statewide Managed Care program,resulting in a 311% increase in accurately coded electronic claims in 12 months.

Recorded, monitored and acted-on case in Medicaid's common issue database, resulting in an 88% drop in open cases within the first 6 months.

Acted as Agency liaison on weekly and monthly calls and training sessions with the 28 contracted managed care organizations.

Assisted the contracted Fiscal Agent in identifying common issues and delivering the relevant solutions to the contracted managed care organizations.

EDI SPECIALIST & OPERATIONS SUPERVISOR – Hewlett-Packard Enterprise (Tallahassee, FL) 2007 – 2014

Oversaw an EDI Operations support team of 5-7 individuals, including monitoring of phone and email queues, reporting on relevant statistics, and attending team and project meetings.

Acted as research lead, taking on investigation of troublesome HIPAA X12 file issues, speaking to dissatisfied customers and assuring issues were resolved - and communicated - within a timely fashion.

Represented EDI Operations as part of the CAQH/CORE compliance team, helping Florida Medicaid to be the first fully certified public payer, and among the first 5% of all payers (public or private) to achieve certification.

Authored, edited and maintained user companion guides, training documents, provider communications and white page documents which were used to inform and train contract employees and the State of Florida's 10,000+ electronic claim submitters.

As part of EDI Operations, assisted with the implementation of Florida's Medicaid Management Information System in 2008.

Education

ASSOCIATE IN ARTS, MATHEMATICS – Miami-Dade College (Miami, FL)

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