Operations Manager Business Analyst
Resume:
Ebonie Murray
BILLING DEPARTMENTAL MANAGER/DIRECTOR
Clearwater, FL 33760
******.*******@*****.***
Professional Summary
Over 20 years of successful supervisory and leadership experience with a reputation for meeting the most challenging organizational goals and objectives. Worked with operations manager to ensure that product delivery and quality objectives are regularly met. Extensive Knowledge in:
• Automating daily manual tasks. Overseen tactical and logistic aspects of the operations process
• Interpret HR classification policies, procedures, and guidelines.
• Analyzes and evaluates programs, identifies problems/deficiencies and provides solutions.
• Developing and maintaining effective relationship by providing external client ready communications
• Sustained Top Secret Security clearance for United Stated Navy
• Fault analysis of data processing systems: Flow share & Snapshots collections & data analysis
• Expertise in office automation to improve existing process of systems, workflow, and computer system capabilities
• Microsoft office Package
• Windows XP/Vista/ Server Operation System
• Java Scripting
• Trouble Ticketing Software (HEAT)
• SQL operating systems
• Relay Health Systems
• Data analytics
#readytowork
Willing to relocate: Anywhere
Work Experience
Business Analyst
Optum
June 2021 to February 2025
Utilize tools like Excel, SQL, and data visualization platforms collect, analyze, and interpret complex healthcare data sets to identify trends, patterns, and insights Analyze healthcare data including patient records, claims, and operational metrics ensuring data integrity Worked closely with technical teams to design and implement solutions that aligned with business objectives and healthcare industry standards
Ensured all deliverables comply with healthcare regulations and standards such as HIPAA, ICD-10, HL7 Analyze end-to-end claims workflows from submission to Payment Accounts Receivable Refunds Specialist
Optum
October 2017 to June 2021
• Resolve credit balances for insurance and patient balances
• Initiate refunds, offsets, and adjustments
• Maintain supporting chronological notes that detail action taken
• Responsible for the accurate and timely resolution of self-pay and insurance credits.
• Partners with the Revenue Cycle Reconciliation Analyst
• Recognizes coding problems and forwards them to coder with records for resolution. Government Billing Specialist
Parallon
August 2013 to October 2015
• Claim follow-up Commercial, Government HMO, Medicaid and Medicare payors
• Strong understanding of the UB-04 form (value codes ICD/CPT Coding, Occurrence codes)
• Working knowledge of DRG, Medicaid reimbursement methodologies and fee schedules
• Reported any internal errors or issues that delay accurate billing of claims
• Prepare and submits insurance claims; reviews and adjusts accounts
• Interpret Explanation of Benefits (EOBs)
• Review claims before submission to insurance carrier; assesses adjudicated claims.
• Creates, organizes, corrects, updates and maintains accounts on data spreadsheets
• Ensures correct and prompt claims payments through confirmation from providers Team Leader/Supervisor Call Center Operations
Nielsen Media
November 2011 to April 2013
• 85% Supervise a team of 10- 25 employees to assure overall quality and productivity 10% Perform administrative processes 5% Preform other related duties and responsibilities as assigned
• Ensure quality service standards are maintained through KPI and BPI reports
• Review call center statistical data and provide monthly benchmark measurements
• Report and resolve system problems efficiently
• Work in coordination with Group Leader to manage daily operations
• Assist Group leader and Training department in the development of team technical knowledge and capability
• Maintain, troubleshoot, and manage corrective action for automates office systems
• High level of engagement with research interviewers consistently monitoring performance,
• Carried out performance measurement, monitoring, and evaluation of CSRs to improve the efficiency of the call center
• Log in to Queues as required during high call volume and/or all hands status
• Maximizes the potential of each employee supervised Senior Billing Specialist for Patient Account Services BayCare HomeCare
September 2004 to 2010
Provided immediate, comprehensive, and overall supervision, management, organization, and implementation of the section and facility of corporate goals. Responsible for managing an assigned portfolio for open or non-performing assets, mitigating loss situations and reducing potential losses.
• Responsible for auditing patient accounts
• Extensive knowledge of claims adjudication process
• Adhere to laws, guidelines, and training of HIPPA
• Verifications of Aetna, Cigna, United and all government insurances
• Medicare and Medicaid verification and collections
• Coordinated billing training curriculum educated process flows and system procedures
• Submitted accurate invoices to payer for product and services provided
• Evaluated terms and fee schedule for all contracts
• DDE and accounts payable experience
• Facilitated timely billing and collection of all accounts receivable to ensure financial stability
• Responsible for the preparation, processing, and reviewing of company financial assets
• Verified that services and products are correctly authorized and required documentation is on file
• Collaborated with collection department to obtain additional information needed to process claims Navy Electronic Technician (SA CTT)
United States Navy
September 2000 to July 2002
Provided support to company personnel through the analysis, and collection of electronic intelligence through controlled systems.
• Responsible for evaluating network systems such as LAN/WAN
• Analyze internet, intranet, and other data communication systems
• Research and recommend network and data communication hardware and software
• Test and evaluate hardware and software to determine efficiency, reliability, and compatibility with existing system, and make purchase recommendations.
• Identified areas of operations that needed upgraded equipment
• Assist users to diagnose and solve data communication problems
• Monitor system performance and provide security measures, troubleshooting and maintenance as needed.
• Train user on use of equipment
• Consult customers, visit workplace and conduct surveys to determine present and future needs
• Monitor action plans related to the implementation of development projects and their progress Education
MBA in Business Management
University of Phoenix - Clearwater, FL
November 2009 to April 2011
Bachelor of Science in (BS) Business Management
University of Phoenix - Clearwater, FL
May 2005 to October 2009
Accounting Licenses
Billing Manager/Director
State: FL
Skills
• LAN
• Computer Networking
• WAN
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