Analyst Developer

Cranberry Township, PA *****

*******@************.*** 724-***-****

Sherri Lynn Gaydos

Experience:

Enrollment/Billing Senior Representative 06/16/2020- Cigna Healthcare Warrendale, PA

● Follows standard operating procedures to edit, bill, and collect payment on basic outstanding claims in pursuit of reducing the company's accounts receivable.

● Requires basic knowledge of the billing and collection processes and general supervision for routine work

Business Analytics Analyst 03/16/2020-4/17/2020

Cigna Healthcare Pittsburgh, PA

● Contributes to the Business Analytics job family in a support capacity, queried data using PLSQL, reviewed and exported data for project reports.

● Analyzes data to inform business and product decisions.

● Performs routine analyses and compiles standard reports.

● Completes output (documents, analyses, product) in specific work area to appropriate time and quality targets.

Associate System Analyst 06/2018-11/2019

United Health Care Pittsburgh, PA

● Reviewed existing legacy application documentation to develop an understanding of the existing functionality.

● Coordinated with business leadership (SME, Product Manager and Product Owner) to clarify business requirements.

● Documented existing business processes and proposes innovative improvements.

● Attended daily standups, created features, user stories and groomed each for respective Sprints.

● Attention to detail on each project to ensure the developer had all relevant details for coding.

● Developed a clear definition and acceptance criteria for each of the features to ensure the business requirements will be addressed.

● Assisted with documentation and prioritization of the business value associated with the business requirements.

Objective

Business Analyst with excellent communication skills and responsive to deadlines.

Business Analyst 01/2017 - 05/ 2018 CVS Healthcare Monroeville, PA

● Lead large and small projects to analyze and translate business needs.

● Worked through detailed technical specifications with the developer to guarantee successful project delivery.

● Analyzed data using PLSQL, queried data, reviewed and exported data for project reports.

● Analyzes data to inform

● Facilitate meetings between CVS IT departments and CVS business owners as well as documentation reviews for sign-offs.

● Followed waterfall project methodology, wrote the business requirements, solutions requirements package, and requirements traceability matrix.

Program Business Analyst2013-2016 CVS Healthcare/Aetna Health Care Cranberry, PA

● Lead other Business Analysts to consistently analyze and translate business needs to create high-quality Business Requirements and Functional Specifications documentation. This work was completed within specified time frames to solve the most complex problems and considers all impacted components from an end-to-end perspective.

● All projects involved working closely with the developers, creating inbound mappings to the legacy system to help the developer code appropriately.

● Communicated Federal requirements for Healthcare Exchanges to multiple departments and contracted vendors.

● Reviewed contracted vendors deliverables and provided detailed requirements to contracted vendors.

● Followed the standard agile project methodology on all projects. Attended daily standups, created features, user stories and groomed each for respective Sprints Sr. Business Analyst 2006 - 2013 CVS Healthcare / Coventry Health Care Cranberry, PA

Responsible for leading the project to implement the 5010 versions of the X12 HIPAA 837 Professional Health Care Claims, 835 Health Care Payment Advice, 834-Benefit Enrollment and Maintenance and 820-Payroll Deducted and Other Group Premium Payment for Insurance Products transaction sets with outside trading partners and our business.

Documentation of functional specifications, requirements traceability matrix (RTM), requirements and business systems design (BSD), and test plans.

Facilitate meetings between Coventry’s IT departments and Coventry’s business owners as well as documentation reviews for sign-offs.

Lead projects using standard project methodology.

Complete all technical reviews of the trading partner’s HIPAA 834 and 837 file layouts for HIPAA Compliance Levels.

Coordinate and train the business on set-up of various applications.

Analysis of all production critical issues and identifies enhancements when necessary.

Create test scenarios to ensure adequate testing of enhancements. Sherri Lynn Gaydos 724/772-2637

Business Analyst 2001 - 2006 CVS Healthcare / Coventry Health Care Cranberry, PA

Worked with planned projects to implement vendor upgrades.

Develop documentation for operations procedures.

Review HIPAA Transactions for compliance guidelines.

Testing with SpecBuilder and CLAREDI to validate compliance levels.

Testing 3051 productions issues for commercial and government programs. EDI Training Support Specialist 1995–2001 Mysis Pittsburgh, PA

Prepare clients software within DOS, UNIX, and SCO UNIX platforms.

Coordinate and train users on set-up of various commercial and governmental carrier specifications.

Analyzed all escalated support calls.

Interpret reports, evaluate ANSI or NSF files for accuracy, and instruct users on corrections.

Maintain and facilitate transitioning clients from transmitting files via a direct connection to transmitting files via company owned clearinghouse.

Administrative Accounting Specialist 1990–1995 Medic Computer Sys Pittsburgh, PA

Processed journal entries, prepared state sales tax returns, regional distribution of company inventory revenue/costs, weekly financial reports for company investments, and balanced monthly accounts.

Managed contract billing database, software licensing and verified contract billing.

Generated invoices, distribution of cash daily and completion of bank reconciliation of all accounts monthly.

Initiated lease processing and worked as a liaison with clients.

Decreased outstanding balances through weekly collection efforts Accounts Receivable Representative 1988–1990 Imagraphics Inc. Pittsburgh, PA

Invoiced collected, posted cash and balanced daily credit card transactions through bank deposits.

Prepared proposals for new clients.

Initiated orders with vendors and coordinated shipments of supplies to clients References Available upon request

Education

Everest University, Pittsburgh, PA 15022 Associates in Specialized Business

Computer Skills Microsoft Office 2010, Project and Visio; Sun Microsystems Application CA Agile, Facets, Integration Software and Exchange Partner Manger Software; Jboss; Red hat; Hadoop; Golden; Toad; RTC, and PLSQL.

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