Analyst Manager
Resume:
***********@*****.***
Louisville, KY
Work Status: Permanent Resident
ROLE CONFIDENT
IT BUSINESS ANALYST
Claims Domain
AGILE
SCRUM
EDUCATION
Masters in Business Administration (MBA)
Jawaharlal Nehru Technological University, India
SKILLS
TECHNICAL SKILLS
MS WORD
MS EXCEL
MS PPT
SQL
PERSONAL SKILLS
COMMUNICATION
CONTINUE LEARNER
ORGANISOR
TEAM LEADER
SOCIAL
INNOVATIVE
PROBLEM SOLVING
COOKING
SPORTS
COMMUNITY SERVICES
HELP HOMELESS
FOOD DRIVE
SCHOOL SUPPLIES
PARKS CLEANING
Ramya Kumari Penta
Business Analyst Claims Processor
4 Years of IT experience in Business Analyst, Requirement Analysis and Medical Claims Processing
4 Years of Domain experience in Healthcare Claims
Experience in Software Development Life Cycle (SDLC), Waterfall Model, Agile methodologies
Committed to professionalism and highly engaged with the customer to deliver data-driven business insights
EXPERIENCE
Business Analyst (Nov 2019 - Present)
Client: RxCrossroads - McKesson, Louisville, KY
RxCrossroads - McKesson Provides Commercial solutions for brand and specialty pharmaceuticals, including third-party logistics, custom pharmacy programs, and patient access and data and analytics solutions.
Responsibilities:
Analyzed the Contracts for different biopharmaceutical companies, Created and updated Functional Required Documents by gathering functional and non-functional specifications contributed to the continuous improvement process for requirements analysis.
Evaluated information gathered from multiple sources, reconcile conflicts, decomposed high-level requirements. I communicated with different Stakeholders, Business Groups, and User groups to elicit and to analyze Business Requirements. Assisted the Project Manager and QA Team, coordinating between team members according to the business requirements.
Created test cases and scenarios and met all project data deliverables and deadlines. Performed unit testing to confirm accuracy, quality, and completion as determined by the established requirements.
Create new Cases in iCMS to validate data and reconcile it with portal data
Responsible for submitting Status Reports to management summarizing completed Milestones and Tasks. Conducted user walkthroughs, documented customer concerns, and communicated to project management teams.
Reported defects along with the QA team and followed up with the development lead to resolving any outstanding defects.
Involved in Okta Implementation and security remediation by testing the Manufacturer and Physicians portals.
Business Analyst (Nov 2018 – Oct 2019)
Employer: MoonIT Solutions, Frisco, Tx
MoonIT Solutions is provider of digital transformation services. Their customer-first approach enables to create innovative digital solutions with focus on providing connected and customized business solutions helping organizations to improve their digital footprint. They work at the intersection of strategy, design and innovation to catalyze change and deliver results. Proven successful delivery of software development solutions for more than 10 years.
Responsibilities:
•Understand the User requirements and help preparing user stories
•Clearly document Business Requirements Specification for IT
•Clarify IT Stakeholders with Business Requirements
•Prepare User Acceptance testing strategy and Test cases
•Perform User Acceptance testing and approve product
•Perform Production Validation after Prod Release
Claims Processor (Apr 2017 - Oct 2018)
Employer: Firstsource Inc, Louisville, Ky
Firstsource is a leading provider of customized Business Process Management (BPM) services. They are specialized in helping clients stay ahead of the curve through transformational solutions in order to reimagine business processes and deliver increased efficiency, deeper insights and superior outcomes. They are trusted brand custodians and long-term partners to 100+ leading brands with presence in the US, UK, Philippines and India. Their ‘rightshore’ delivery model offers solutions covering complete customer lifecycle across Healthcare, Telecommunications & Media and Banking, Financial Services & Insurance verticals.
Responsibilities:
•Investigate, analyze, and determine the extent of insurance company's liability concerning personal, casualty, or damages, and attempt to effect settlement with claimants.
•Correspond with or interview medical specialists, agents, witnesses, or claimants to compile information.
•Calculate benefit payments and approve payment of claims within a certain monetary limit.
•Analyze information gathered by investigation and report findings and recommendations.
•Examine claims form and other records to determine insurance coverage.
•Interview or correspond with respective units and to correct errors or omissions and to investigate questionable claims.
•Prepare report of findings of investigation.
•Refer questionable claims to investigator or claims adjuster for investigation or settlement
PREVIOUS WORK EXPERIENCES
1.MoonIT Solutions (Nov 2019 - Present)
Role: Business Analyst
Client: RxCrossroads - McKesson
2.MoonIT Solutions (Nov 2018 – Oct 2019)
Role: Business Analyst
3.FirstSource (Apr 2017 - Oct 2018)
Role: Claims Processor
4.JCPS – Substitute Teacher (Jan 2016 – Mar 2017)
Role: Substitute Teacher
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