Analyst Salesforce

JOSEPH J. PRIDMORE

**** ****** ***, **** **********, CA 95691 916-***-****

********@*****.*** Linkedin.com/in/joe-pridmore

SENIOR BUSINESS ANALYST

Extensive technical experience in the healthcare industry analyzing, planning, implementing and documenting business requirements for systems integration. Highly capable of discovering and resolving complex issues using a variety of analytical tools. Comprehensive knowledge in the medical data processing and workers’ compensation industry, medical terminology (CPT, ICD-9 and ICD-10), plus Medicare and Medicaid processing experience.

Work with customers at all levels within the organization and outside parties to identify operational business requirements to implement successful systems integration. Strong team member with ability to work as a leader and independently. Detail oriented with a proven track record of systems analysis and IT support.

TECHNICAL SKILLS

Software

MS Office Suite, Oracle, SQL, SharePoint

Analytics Tools

IBM Cognos Analytics, Remedy Ticket System

Data Management

Workers’ Compensation Management System (WCMS), Aetna Bill Review System, Managed Care Pricing System (MCPS)

EXPERIENCE

COGNIZANT/TRIZETTO PROVIDER SOLUTIONS, Sacramento, CA

Reimbursement/Technical Analyst 8/11/19 – Present

Monitor current Medicaid Fee Schedules and load updates into the Trizetto system. Work in SalesForce to create and monitor Fee Schedules on a daily basis and work with clients on updates. I also monitor appeal form updates for Medicaid states.

Account Manager Feb. 2019 – 8/10/2019

Ensure I am delivering the highest level of customer service to our clients; accurately log all communication, provide timely follow up, communicate professionally, and consistently produce work of exceptional quality. Update SalesForce with monthly and annual business review reports for each client. Create Project Implementation Plans for all new clients and log information into SalesForce. Responsible for all client escalations and internal issues.

AETNA, West Sacramento, CA 2003 – 8/15/18

Senior Business Analyst – Workers’ Comp IT, 2003 – 2018

Business Analyst, 2003 – 2008

Accountable for data management, data analysis, documentation of information, and presentation of findings. Served as Main on-call support personnel for Bill Review System.

Joseph Pridmore 916-***-****

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Use Remedy Ticketing System to troubleshoot bill processing and file issues; lead support team of developers and systems engineers to resolve issues in a timely manner and to avoid system downtime. Continuously exceeded response goals for IT Support

Experience in all phases of systems integration, including gap analysis, data modeling and mapping, documentation, testing, production support and training to improve processes. Data mapping eliminates duplicate billing.

Conduct, research and review client business processes and functional requirements for integration to confirm processes aligned with business requirements.

Support clients, vendors and internal users on system performance and maintenance issues to resolve issues, such as billing errors.

Review business requirements to develop fee schedule pricing and regulation implementation for clients in any given state.

ADDITIONAL RELEVANT EXPERIENCE

COVENTRY, West Sacramento, CA 1991-2003

Test Team Analyst

Fee-schedule Specialist

OCCUPATIONAL URGENT CARE HEALTH SYSTEMS (OUCH), Sacramento, CA 1987-1991

On-site Specialist

Assistant Supervisor

Bill Processor

EDUCATION

Data Entry Certification, MTI Business College, Sacramento, CA

References available upon request.

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