Athena Lawyer

ad1j4q@r.postjobfree.com

717-***-****

PROFESSIONAL SUMMARY

Over 25 years of experience in the health care industry with a proven track record of achieving the successful implementation of software solutions to directly support business objectives. Over the years her roles and duties have evolved from mainframe application developer, database administrator to business analyst. The duties and skills she has developed from these roles make her a unique candidate. She has over 17 years of experience doing the duties of a mainframe application developer. Additionally, in her roles as business analyst, she was able to leverage her mainframe developer skills. She has extensive experience working in a full software development life cycle. She can quickly grasp and advance knowledge through research. She has outstanding multi-tasking and prioritizing skills that allow her to coordinate and balance assignments. She has strong professional communication and organizational skills.

TECHNICAL SKILLS

PeopleSoft, Rational Tools, Microsoft Office Suite, MS Project, VISIO, SQL queries, Teradata, SQL server, Oracle, PDM, ClearQuest, SharePoint, Assembler, COBOL/COBOL II, IMS, DB2, CICS, JCL, TSO

PROFESSIONAL EXPERIENCE

Senior Systems Analyst (October 2021 – April 2023)

Global Data Consulting – Leidos

Provided support to the software development team that was responsible for providing logistics systems to the military services and defense agencies of the Department of Defense (DoD)

Worked on a team that worked directly with stakeholders to gather and document functional and technical requirements and collaborated with internal development teams to deliver solutions that satisfied the business needs

Participated in the agile software development process and prepared detailed requirement specifications in the form of user stories or functional requirement documents for development teams

Created and executed test cases/scenarios and detailed acceptance criteria

Assisted the Help Desk with problems and incident management

Full Time Student (Fall 2020 – May 2021)

HACC - Web Development & Design – Certificate

Application Developer (January 2018 – October 2019)

HM Health Solutions – United Concordia Dental

Responsible for analyzing, designing, coding, testing, and implementing application enhancements, as well as providing general production support, meeting define scope, target dates and budgets with no defects

Collaborated with customers, business analysts, and IT team members to understand business requirements that drive the analysis and design of quality technical solutions. Concentrated on providing innovative solutions to business needs

Effectively communicated with team members, customers, and management, including assisting with technical walkthroughs, reporting project status, and providing accurate and concise documentation

Performs work in compliance with all Highmark and Highmark IT standards, policies, and procedures

Utilized and participated in the full system development life cycle, per Highmark SDLC standards

Provided required technical support, including release implementations, on-call 24X7 supports when necessary

Senior Technical Business Analyst (June 2015 – September 2017)

Mindtech - Highmark Inc.

Responsible for various Highmark Interfaces including Manual Payment, REGS, and Blue Magic

Responsible for converting various Highmark interfaces (manual payment, OSCAD) and common applications (ECS, ICIS) to the common GLT/ICA processing

Collaborates with customers, application developers, project managers and team members to understand business requirements and develop technical solutions

Knowledge of JCL, COBOL, DB2 and SQL leveraged to do comprehensive researching and testing

Responsible for documents and deliverables, including customer sign-off

Accountable for all aspects of testing, including unit, system, integration, UAT testing, implementation checkout and post implementation support

Experience using Rational Tools and Agile

Senior Business Analyst (July 2011 – April 2015)

Gebbs Healthcare Solutions - Horizon BlueCross and BlueShield

Responsible for 27 national accounts

Collaborated with individuals at all levels of the organization

Responsible from gathering and defining business requirements to designing, programming, testing, implementing, and supporting new business as well as enhancements to existing business

Working directly with the vendor, customer, plans and technical to develop business requirements and technical solutions

Collaborate with customer to complete and approve User Acceptance Testing

Responsible for change input / outputs, system impact and approvals, code changes and wrote test plans (UAT, stand alone, integration)

Benefit file coding for new accounts, new products, renewals, benefit changes, benefit maintenance, HCR, ACA, State and Federal Mandates, PLOG resolution and performance group audits

Develop efficient benefit coding by reviewing benefit descriptions including NAEGS, and BIFs, converting them to NASCO NPS benefit mnemonics

Product knowledge includes Direct Access, CMM, PPO, EPO

Senior Business Analyst (July 2009 - June 2011)

TEKsystems Inc.- CareFirst BlueCross and BlueShield

Responsible for 17 accounts, some offering as many as 7 different products to over 10,000 members

Responsible from gathering and defining business requirements to designing, programming, testing, implementing, and supporting new business as well as enhancements to existing business

Worked directly with the vendor, customer, plans and technical teams to develop business requirements and technical solutions

Responsibilities included ILOG resolution, requesting reports, and benefit file coding for new accounts, new products, renewals, benefit changes, benefit maintenance, HCR, ACA, Federal and State Mandates

Responsible for migrating accounts from CARE and Flexx local systems to NASCO

Knowledge of various products including EPO, PPO BluePreferred, BlueChoice, Traditional BCBS Major Medical

Senior IT Specialist (May 2008 - June 2009)

IBM – Horizon BlueCross and BlueShield

Provided support to Horizon’s Production Support Division

Responsible for PLOG resolution, Membership file fixes, and GENO maintenance

Supported a special authorization project for the plan’s PPO and POS business

Responsible for system changes to meet business objective and review testing output to ensure the test scenarios were complete and adequate to test the system changes

Database Administrator (May 2006 – May 2008)

IBM - NASCO Claims Processing System

Reviewed and created SQL queries in DB2 programs and JCL

Created and maintained JCL to perform database backups and reorgs

Reviewed and approved Application Developers DB2 programs for efficiency and standards

Programmer Analyst (2000 – May 2006)

IBM - NASCO Claims Processing System

NASCO Claims Processing System transition from EDS to IBM

Extensive experience in all areas of claims processing with an emphasis on claims payment; includes benefits, utilization review, COB, and referral/authorization processing

Collaborated with individuals at all levels of the organization

Responsible from gathering and defining business requirements to designing, programming, testing, implementing, and supporting new business as well as enhancements to existing business

Reviewed and wrote SQL queries in DB2 programs and JCL; pulled data and matched against program test results

Technical Advisor for the ClaimCheck version 8.0 project

Worked directly with the vendor, customer, plans and IBM technical to aid in the development of business requirements and technical solutions

Subject Matter Expert (SME) for the Payment Resolution Subsystem

Programmer Analyst (1993-1999)

EDS

Application Developer and a Subject Matter Expert (SME) supporting Massachusetts Blue Cross/Blue Shield Processing System (MTPS)

Her primary role was to design, code, and implement solutions to meet business objectives

She focused primarily on new business applications and the integration of third-party vendor software

Real Estate Agent (1990 -1993)

Century 21 Piscioneri Realty Inc.

1992 One Million Dollar Award

CACI ( 1984 – 1990)

Programmer Analyst

Design, development, and implementation of an Ammunition Inventory Management System using optical scanning technology and equipment

System was developed on a mainframe platform and produced offline reports, interactive on-line sessions, and batch jobs

Provided on-site operations training to computer operators during implementation of the system at eight different locations in the United States

EDUCATION

Harrisburg Area Community College

Associate of Arts

CERTIFICATES

Medical Billing and Coding Specialist

Web Development and Design

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