Analyst Data
Resume:
Larry Perrymond **** Windsor Knoll Dr, Dacula, GA 30019
**********@*****.***
BUSINESS ANALYST – HEALTHCARE
Business Development Project Management Consulting
Expertise in healthcare billing, claim lifecycles, and associated software development, enhancements, and implementation. SME on claims I&T, QA, and documentation. Record of effectively managing secondary claims, claims adjudication, and 277 & 999 claims reporting. Maintain awareness of changes in current healthcare trends and regulations. Led 5010 implementation; currently following ICD 10 development. Adept at assisting clients and resolving with claim rejections payments and reporting. Ability to effectively manage multiple priorities in dynamic, challenging environments. Proficient at quickly learning new applications, processes, and procedures. Technical and computer skills include 5010 and ICD10 software. Received multiple performance-related promotions. HIPAA Transactions 837,834,820,999,835 and 277 (HL1-7).Health Care Reform (Colorado Health Exchange), SQL experience, SDLC, work with India on technical enhancements, CA Agile tool, Worked Agile environment.
Electronic Management Systems I’ve worked on
Nextgen EHR & EMP, Amisys, Monument, Xcely, Ika, MMIS, NDM, SSI claim system & Facets
CAREER TRACK
Sr. Business Analyst Oct 2018-Aug 2020
Carefirst (Contract position) Washington, DC
Experience in business process analysis, Work flow, task analysis, User acceptance testing and requirements analysis.
Proven ability to elicit, document, analyze and verify requirements.
Technical writing experience and training experience.
Experience leading business/technology enhancements, automations and implementations.
Experience in accurately modeling requirements using at least one if not more of the following: Functional Decomposition, Data Flow Diagrams, User Context Diagrams, Activity Diagrams, Decision Needs, Workflow modeling, Use Cases, Use Case Model Survey and Use Case Specification, Process Modeling, Prototyping.
Experience in coaching and mentoring other associates as well as leading small teams of junior analysts.
Demonstrated successful use of SDLC methodology or demonstrated knowledge of business processes related to the business area supporting.
Review Policies and write related documents for tech team to code.
Conduct Analytical Studies, gather, organized and interpret data.
Strong experience with testing concepts.
Lead problem-solving discussions.
Use industry standard requirements gathering and modeling techniques to understand and communicate the needs of the product’s users.
Sr. System EDI Analyst Jan 2018-Oct 2018
Axiom Systems (Contract) Frederick, MD
Serve as a subject matter expert working within the product development team and with clients to identify impacts and analyze issues.
Implement product solutions based on customers’ business needs.
Perform client assessments and write details reports.
Support activities such as testing and system integration.
A conduit to help our project team understand the configuration and how that affects the current business that are pre-configured before information is loaded into the client system.
Configuration of claims, enrollment and pricing.
Strong Business Analyst with Payer and Providers.
Use of HIPAA X12 transaction set (HL7), translate technical requirements into business needs, and document technical and business specifications.
Sr. Business System Advisor May/2013-Sept 2017
Dell Atlanta, Georgia
Work with Business users to define and analyze problem and align the most appropriate technical, application or configuration solution.
Conducts business process analyses, needs assessments, and preliminary cost/benefits analyses in an effort to align information technology solutions with business initiatives.
Solicits, develops, documents and manages requirements and provides detailed design and business rules to support the requirements throughout project life cycle up to and through change control.
Reviews system test plans and system tests modules before implementation.
Creates reviews and delivers end-user documentation (user guide, process flow charts, and training materials) and training for accuracy.
In upgrades, monitors production performance enhancements and system integrity with end-users.
Develops detailed implementation and upgrade project plans in conjunction with other account team associates.
Ensures that documentation is updated when change requests are approved for the project.
Work to keep all claims and business HIPAA compliance.
Create test plan for projects.
Mentor team on projects and data migration.
Work with Offshore on technical software enhancements.
Serves as the subject matter expert and consulting resource for the client.
Sr. Business Analyst Advisor January/2013-Febuary/2013
ACS/Xerox Denver, Colorado
Analyzes business processes and performs needs assessments in an effort to align information technology solutions with business initiatives.
Interprets business needs and translates them into system requirement
Work in HIPAA compliance (HL 1-7) for claims and client business.
Writes business specifications and forwards to technical staff for system development
Provides technical expertise in identifying, evaluating and developing systems and procedures that are cost effective and meet user requirements.
Configures system settings and options, plans and executes acceptance testing, and creates specifications for systems to meet business needs.
Conduct system Testing and Reporting
Mentor team on projects and data migration
Interact with internal and external teams Colorado Medicaid Staff and Stakeholders
Created Use Cases for projects assigned (Rural Health,)
SR. Business Analyst June /2011- October/2012
United Healthcare / Ingenix / Optimuminsight Colorado Springs, Colorado
Saved Company thousands of dollars by single-handedly gathering over 400 payers (Medicaid, Medi-cal, BCBS, and Commercial payers) 5010 HIPAA requirements for migration, customizing specs for each payer, and adding enhancements or edits that enforced new conditions; created 837I and P EDI files to support enhancements
Provide requirements interpretation and guidance to technical team.
UAT testing for 5010 added 5010 edits and payer logic
Working with Edifec Tool for claims mapping and testing.
Ensure clients meet requirements and comply with 5010 standards by serving as primary POC.
Analyze ANSI data files to determine accuracy of payer claim submissions; correct rejected claims by manually creating 999 or 277 reports.
Documenting and analyzing business processes and recommending improvements.
Wrote Use Cases and Test Plan for 4010 and 5010 projects
Mentor team on projects and data migration
Sr. System EDI/ Development Advisor February /2008 –June/ 2011
NextGen Healthcare (Electronic Management System) Atlanta, Georgia
Utilized EPM application and collaborated with Development to enhance satisfaction of ERA and RTS clients.
Assisted clients with claim adjudication rejections by interpreting rejection codes and correcting resubmitting claims. Payers include Medicaid, Medicare, Medi-Cal and Commercial Payers
Research claims errors using Edifec and Nextgen claims edit tool.
Researched and wrote specs for claims / billing / ERA (claim Adjudication) and RTS (Real Time Transaction) enhancements and regulatory changes.
UAT testing when enhancements and changing are made to Nextgen software.
Ensured software compatibility with claim adjudication 837 (I and P) 277, 999, and ICD 10 changes by developing 5010.
Trained clients on using EPM application for secondary billing and ERA.
Eliminated many application issues by initiating new ERA process.
Mentor team on projects and data migration
Document business process and recommend improvements
Contributed to client implementations by providing training on building claims in EPM software, advising on payer requirements to prevent rejections, ensuring claim accuracy by recommending application of payer-specific edits, and creating reports to track claim AR.
Payer Implementation Manager November /2005 - February/2008
MedAvent Healthcare Norcross, Georgia
Provided business analysis, technical, and analytical support; tested X12 industry formats and ensure payer projects complied with HIPAA regulations.
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Larry Perrymond Page 2
Conducted analysis to support classification of claims processing; assigned system, policy or training categorizations.
Enforced accuracy of vendor partner claim submissions by analyzing ANSI data files.
Elevated end-user satisfaction by changing program edits and interpreting carrier reports.
Improved customer relations and reduced incoming call volume by educating clients on transmission report errors.
Billing Administrator September/2005-November/2005
ApolloMD Atlanta, Georgia
Ensured correctness of all claims and successful export to Payer Path by operating GMPS; tracked claims transmission & receipt by creating balancing spreadsheet and monitoring payer accounts.
Maintained accuracy of coding by conducting test edits.
SUPERVISOR September/2002 –September/ 2005
HCA Healthcare Norcross, Georgia
Operated and managed SSI billing system; developed bi-monthly maintenance process.
Quickly resolved discrepancies by verifying actual data on a daily basis.
Performed test edits to guarantee accuracy of ICD9 coding and ensured payers received claims files by managing accounts; notified insurance payers about transmission problems.
Electronically transmitted HCA Hospitals’ claim files and corrected rejected 837I and 837P claims.
Effectively served as Billing Department Lead whenever needed.
Implementation Specialist September/2000 –September/ 2002
Medunite Norcross, Georgia
Provided leadership to new employees while managing communications between Payers (Medicaid, Medicare, Medi-cal, BCBS and Commercial) customers and serving as liaison between Customer Support and Development Departments.
Optimized integrity of provider data and determined liability for missing claims by reviewing records.
Conducted troubleshooting on provider data to guarantee successful file submission.
LEARNING CREDENTIALS
Biology Studies 1993 - 1998
Savannah State College & Morris Brown College
BA Biology Morris Brown College Atlanta, Georgia
CLASSES AND CERTIFICATE
Nextgen EHR Certified
BA Certificate
Project Management
REFERENCES AND FURTHER DATA PROVIDED UPON
ESTABLISHMENT OF MUTUAL INTEREST
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