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Manager Life Insurance

Location:
McKinney, TX
Posted:
September 20, 2016

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Resume:

Terry A. Williams

972-***-**** acwpau@r.postjobfree.com 1108 Lubbock Lane Melissa, TX 75454

Applicant Summary:

Individual performer, technical lead and management level experience, including emphasis on system enhancements, system conversions as well as revenue generation.

Experience within programmer, data analyst and client point of contact roles.

High performance, results oriented track record at Electronic Data Systems (EDS-HP) and Health Management Systems (HMS).

Technical Experience / Skills Summary:

SAS: 11 years of experience (mainframe, PC SAS and UNIX, WPS)

COBOL: 20 years of experience

JCL: 20 years of experience

TSO/ISPF: 20 years of experience

Additional experience/skills: DB2, Teradata, SQL, VSAM, IBM MVS Mainframe Utilities, DYL280, File Aid, Endevor, Easytrieve, EDS SE Utilities, Intertest, Visual Basic, ANSI C, Tandem, ADW, CHAMP, SLC methodologies, OS/2, MS Access, Control-M, Assembler, Toad

Career Summary:

Viverae, Inc.: May 2015 – Current

Title: Claims Integration Manager

Environment: WPS, MySQL, Toad, SQL

Responsibilities: Commercial Insurance claim and eligibility file reformat team manager. Lead of team of analysts, defining new client files and update specifications. Interface with carriers, ETL definition, claims data reporting. Creation, development and maintenance of SAS code generator used for file vetting and data anomaly identification.

Health Management Systems: June 2014 – May 2015

Title: Team Lead / Paid Claims Analyst

Environment: COBOL, SAS, DB2, Teradata, SQL, Toad, mainframe, IBM Utilities, Microsoft Excel/Word/Access

Responsibilities:

Lead team of analysts responsible for interfacing with internal customers and external clients to develop system enhancement specifications for paid claims reformat process.

Paid claims analyses across multiple platforms for several HMS MCO and State Medicaid contracts.

Data Expertise:

Breadth of data expertise spans Medicare and Medicaid Professional, Dental, DME, HMO Capitation, Skilled Nursing, Hospice, Inpatient, Outpatient, Pharmacy, Institutional and Professional Crossover claim types, as well as Provider and Recipient/Eligibility data. Familiar with ICD9/10, HCPCS and CPT coding.

Artech Information Systems LLC: January 2014 – June 2014

Title: Contract SAS Programmer (American Airlines)

Environment: TSO/ISPF, SAS (mainframe and UNIX)

Responsibilities: Flight Crew analysis, reporting and compensation.

Health Management Systems: March 2005 - January 2014

Title: Overpayment Recovery Manager / Program Integrity Data Miner

Environment: SAS, DB2, Teradata, SQL, Toad, mainframe, COBOL, IBM Utilities, Microsoft Excel/Word/Access

Responsibilities:

Develop and execute claims recovery processes in support of overpayment recovery endeavors.

Responsible for the creation, maintenance and modification of in house HMS software to support claims analysis and recovery processes, execution of data extraction and evaluation in support of RAC (Recovery Audit Contract) recoupment projects.

Delivery of recoupment projects to HMS client facing staff and formatting supportive file data for recoupment vehicles.

Mentor and manage incoming staff on technical, industry and environmental aspects of Recovery Analyst and Data Miner roles.

Responsible for development and release of disallowance projects resulting in annual recovery of several million dollars on behalf of multiple HMS Medicaid clients.

Support core business (TPL recovery) data quality enhancements.

Electronic Data Systems: January 1990 – March 2005

Customer: ING April 2004 - March 2005

Title/Role: Information Specialist / Technical Lead for Preferred Loan Project

Environment: TSO/ISPF, COBOL, CICS, DB2 development

Responsibilities: Lead team in effort to design and implement alternative loan crediting method to allow ING to remain in contractual compliance. Enhance Ingenium mainframe/DB2 life insurance environment to allow for Preferred Loan administration.

Customer: Safety Kleen November 2003 - April 2004

Title/Role: Information Specialist / SAP Security Administrator

Environment: SAP administration

Responsibilities: Create and maintained security profiles for SAP environment. Support overall scheme change to base profiles.

Customer: State of Arkansas Medicaid April 2003- November 2003

Title/Role: Information Specialist / Programmer, Analyst

Environment: Tandem, COBOL Development

Responsibilities: Support HIPAA changes to Medicaid system for institutional and professional claim types. Completed changes to ADW generated COBOL code in Tandem environment.

Customer: Amerus Life December 2001 - April 2003

Title/Role: Information Specialist / Technical Consultant-Lead

Environment: TSO/ISPF, COBOL, CICS, DB2 development

Responsibilities: Serve as technical advisor for conversion of life insurance block from Vantage system to Ingenium DB2 environment. Perform technical responsibilities related to APEX upload and ‘clocking forward’ of policy block.

Customer: Lincoln Life November 2000 - December 2002

Title/Role: Information Specialist / Technical Lead for conversion efforts

Environment: TSO/ISPF, COBOL, CICS, DB2 development

Responsibilities: Complete design and coding of valuations interfaces for post conversion. Lead team in effort to convert three blocks of life insurance policies onto Ingenium DB2 environment through use and development of Visual Basic/MS Access code generator and APEX upload process.

Customer: Jackson National Life July 1992 - November 2000

Title/Role: Information Analyst / Programmer, Analyst

Environment: TSO/ISPF, COBOL, CICS, VSAM development

Responsibilities: Serve as business contact and technical expert for Equity Plus base files for policy issuance and policy illustrations. Implement technical enhancements to Equity Plus/VSAM mainframe life insurance system. Design and implement forms for Visual Basic new policy entry system. Serve as expert on mainframe file data, including updates, data extraction, reporting and modification.

Customer: GMC Truck January 1990 - July 1992

Title/Role: Customer Relations Manager

Environment: Call Center

Responsibilities: Respond to incoming calls for district customer concerns. Interface with dealer service managers for customer issue resolution.

Education:

Bachelor in Communication Arts and Sciences

Michigan State University



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