Customer Service Business Analyst

Joseph D. Liberta

**** **** **** ****

Lancaster, NY 14086

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

OBJECTIVE

To obtain a position with your company where I know I will be an asset and will apply myself to my fullest capabilities.

PROFILE

Skilled employee with over 10 years experience in management and customer service.

Extensive background in hiring and training personnel, organizing and managing distribution routes, as well as direct interaction with customers.

Proficient in several applications, including these:

Microsoft Excel

Microsoft Word

Microsoft PowerPoint

Sequel

PROFESSIONAL EXPERIENCE

Fidelis Care, Buffalo, NY 3/20 - present

Operations Configuration & Integration Analyst -

Analyze, interpret, load, test and maintain configurable tables, files and software that are utilized to support claim adjudication which include and but are not limited to; claim adjudication rules edits, benefit plan support, and provider reimbursement rules

Research and resolve claim problems or issues that are configuration related in a timely and accurate manner

Interacts and coordinates system programming changes and schedules as necessary with Business Analysts and Programmers

Fidelis Care, Buffalo, NY 3/18 – 3/20

Claims Business Analyst -

Create test data and execute User Acceptance Testing to implement changes to Facets system

Review and report defects when found on test cases to ensure all errors are corrected

Perform analysis and testing on multiple team projects within the company

Communicate status of projects with colleagues and management

Assist in training new team members to familiarize them with testing procedures and programs

Fidelis Care, Buffalo, NY 3/17 – 3/18

System Resolution Coordinator –

Resolve claim disputes

Review provider contracts for pricing disputes

Review member’s summary of benefits, claim history and enrollment status to make an informed decision

Familiar with CPT/HCPC and IDC10 coding, guidelines and procedures

Fidelis Care, Buffalo, NY 08/16 – 3/17

Claims Review Analyst -

Verify and update information on submitted claims

Communicate with management the issues that may affect the review

Identify billing trends

Fidelis Care, Buffalo, NY 01/16 – 8/16

Claims Processor -

Input detailed data into accounts within the database; open and review claims using available documentation

Follow organization standards and adhere to departmental, state, and federal guidelines

Recognize trends and identify the problems

Skilled in processing Medicare claims

Fidelis Care, Buffalo, NY 05/15 – 01/16

Authorization Coordinator –

Communicate with providers regarding authorizations, modifications, denials and other matters pertinent to processing authorization requests

Responsible for meeting the performance measurement standards for productivity and accuracy for processing of authorizations

EDUCATION

Buffalo State College, Elmwood Avenue, Buffalo, NY 1999-2003

Bachelor of Arts in History

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