Business Analyst

CURTIS J. MILES

Lawrenceville, ***** Ga.

*************@*****.*** / 706-***-****

PROFILE

Seasoned Senior Business Analyst with a proven track record of driving business success through strategic analysis and innovative solutions. Highly skilled in business process modeling, data analysis, and requirements elicitation, leveraging technical proficiency in tools like SQL and Power BI to deliver actionable insights. Known for exceptional critical thinking, problem-solving, and stakeholder management, ensuring alignment between business objectives and project outcomes. Adept at collaborating across cross-functional teams, mitigating risks, and adapting to dynamic business environments to deliver measurable results.

SKILLS

Business Process Modeling

Data Analysis and Reporting

Requirement Elicitation

Technical Proficiency

Risk Assessment

Communication and Collaboration

Critical Thinking

Stakeholder Management

Leadership

Adaptability

EMPLOYMENT HISTORY

Sr. Business Analyst / Zelis 05/2023 - 07/2024

Led the development and implementation of a strategic product roadmap, effectively aligning customer demands with organizational objectives to enhance innovation and deliver measurable value.

Acted as the central communication bridge between cross-functional teams and stakeholders, ensuring clarity, alignment, and timely execution of project deliverables.

Collaborated with stakeholders to identify, document, and prioritize complex product requirements, optimizing feature development for maximum business impact.

Managed and guided a multidisciplinary team to deliver high-quality product features on time, upholding stringent quality standards and best practices.

Designed and maintained a dynamic product backlog, facilitating the prioritization of user stories, streamlining workflows, and promoting efficient development cycles.

Business Analyst/IT Quality Control Analyst (UAT Tester) / ANTHEM/BLUE CROSS BLUE SHIELD OF GEORGIA 01/2016 - 05/2023

Directed and implemented QA processes to identify and resolve software defects, ensuring system reliability and adherence to industry best practices.

Oversaw defect triage processes, including identifying, documenting, and tracking bugs to resolution, maintaining high application quality standards.

Conducted functional, regression, usability, and end-to-end testing to validate software functionality and deliver seamless user experiences across platforms.

Developed and executed detailed test cases using tools such as JIRA, ensuring comprehensive test coverage and clear documentation of results for team collaboration.

Collaborated with stakeholders, including business analysts, developers, and project managers, to refine requirements, enhance acceptance criteria, and ensure the delivery of robust software solutions within agile frameworks.

Financial Operations Analyst / ANTHEM/BLUE CROSS BLUE SHIELD OF GEORGIA 10/2014 - 01/2016

Assisted in implementing financial application software releases and participated in system testing to ensure seamless integration.

Resolved escalated claims and premium-related customer inquiries through effective and detailed communication.

Analyzed financial data and business systems to identify areas for improvement and provided actionable recommendations.

Collaborated with sales, underwriting, and operations teams to manage weekly and monthly billing processes.

Ensured accurate financial reporting by maintaining balance sheets, addressing exceptions, and resolving billing issues with processors.

Medical Claims Negotiator / IHealth Technologies 01/2013 - 09/2014

Negotiated and secured favorable settlements for medical claims, consistently achieving high success rates in recovering additional payments and maximizing revenue.

Analyzed complex medical claims to validate accuracy, assess eligibility, and determine appropriate settlement amounts in compliance with policies and regulations.

Collaborated with insurance providers to expedite claim submissions and ensure timely resolution, maintaining strong professional relationships with carriers.

Conducted thorough investigations of claims data to identify fraud, abuse, or discrepancies, significantly reducing unnecessary claim costs and ensuring compliance.

Leveraged data-driven insights to propose process improvements, streamlining claims management and enhancing operational efficiency.

Business/Benefits Analyst / Wellpoint/Blue Cross Blue Shield of GA 01/2009 - 01/2012

Conducted comprehensive stakeholder interviews to identify and document business and benefits requirements, ensuring alignment with strategic objectives.

Created detailed specifications and workflows to facilitate the implementation of benefits solutions and optimize operational processes.

Evaluated risks associated with proposed benefits programs and designed actionable strategies to mitigate potential challenges.

Delivered insightful reports and presentations to senior management, summarizing key findings, trends, and data-driven recommendations.

Partnered with cross-functional teams to enhance decision-making processes and spearhead continuous improvements in benefits administration.

Customer Support Specialist/Claims Analyst / Wellpoint/Blue Cross Blue Shield of GA 08/2003 - 01/2009

Assisted in developing and streamlining claims handling procedures, resulting in improved operational efficiency and accuracy.

Conducted in-depth analysis of claims data to detect trends, identify fraud, and support cost-saving measures, reducing claims costs significantly.

Designed and implemented customer support systems to enhance interaction quality and elevate overall customer satisfaction.

Trained and mentored support staff on industry best practices, contributing to a measurable improvement in service delivery and client retention.

Generated actionable insights and recommendations based on data analysis, driving enhancements in claims processes and customer support strategies.

EDUCATION

Master of Science: Information Systems 01/2012

UNIVERSITY OF PHOENIX

Master of Science: Accounting 01/2011

UNIVERSITY OF PHOENIX

Bachelor of Science: Business Management 01/2008

UNIVERSITY OF PHOENIX

Computer Information Systems Diploma 01/2002

Columbus Technical College

WEBSITES

https://www.linkedin.com/in/curtis-miles-cspo-97206059/

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