business analyst resume example with 4+ years of experience
JessicaClaire
, , 100 Montgomery St. 10th Floor(555) 432-1000, resumesample@example.com
Summary
Goal-oriented Healthcare Manager successfully assists companies by developing and implementing updates to operational standards, team organization and employee engagement strategies. Proactive and personable leader with top-notch skills in streamlining information, prioritizing tasks and approaching issues with analytical mindset. Bringing years of experience and demonstrated track record of success.
Skills
Data Compiling
Report Generation
Process Improvement
Customer Communication
Project Management
Business Process Improvement
Verbal and Written Communication
Billing Data Verification
Expense Tracking
Services Rendered Documentation
Behavioral Health Claims
DME Claims
Data Analysis
Conflict Resolution
Process Monitoring
Spreadsheet Tracking
CRM and Office Management Software
Project Planning
Onboarding and Orientation
Team Leadership
Budget Management
Administration and Reporting
Employee Coaching and Motivation
Team Building
Complex Problem Solving
Data Entry
Proposal Writing
Invoicing and Billing
Workforce Management
Event Coordination
Case Assessments
Critical Thinking
Process Implementation
Risk Management
Time Management
Quality Assurance Controls
HIPAA Guidelines
Patient Care Assessment
Experience
01/2022 to CurrentBusiness AnalystAtrium Staffing | Iselin, NJ,
Managed projects and served as primary liaison between client and multiple internal groups to clarify goals and meet standards and deadlines.
Delivered timely support by tracking issues and communicating resolutions to end users.
Identified and analyzed user requirements, procedures and processes to develop optimization strategies.
Communicated with customers, competitors and suppliers to stay abreast of industry or business trends.
Communicated with clients by phone and email to answer questions and offer services.
Engaged customers and provided high level of service by carefully explaining details about documents.
Addressed credentialing requests, overseeing compliance with governmental and organizational guidelines regarding tiered data access.
Completed enrollments into Medicaid, Medicare and private insurance plans.
Maintained informational resources, tracking and documenting requests for updates, certification and credentialing.
Set up NPI numbers for providers and facilities and updated current profile information.
Maintained current knowledge of equal employment opportunity and affirmative action guidelines and laws.
Advised management on organizing, preparing or implementing recruiting or retention programs.
08/2021 to CurrentSr. Care ManagerMercy College | Bronx, NY,
Audited charts to drive accurate and thorough documentation, supporting reimbursement of services rendered.
Facilitated communication between members of health care delivery while involving clients in decision-making processes to minimize service fragmentation.
Explained policies, procedures and services to patients.
Maintained communication and transparency with governing boards, department heads and medical staff.
Maintained records management system to process personnel information and produce reports.
Established solid relations with leadership and staff by attending board meetings and coordinating interdepartmental information exchanges.
Planned and implemented programs for health care or medical facilities supporting personnel administration and training.
Communicated with patients with compassion while keeping medical information private.
Attended and actively participated in meetings to provide and receive information on patient progression.
01/2021 to 08/2022Office ManagerAmerisourcebergen Corporation - Corporate | Schiller Park, IL,
Managed office inventory and placed new supply orders.
Monitored payments due from clients and promptly contacted clients with past due payments.
Oversaw receiving and organizing correspondence, answering and forwarding calls and creating business letters and records.
Reviewed files and records to obtain information and respond to requests.
Managed, scheduled and coordinated office functions and activities for employees.
Implemented and maintained company protocols to facilitate smooth daily activities.
Managed office budget to handle inventory, postage and vendor services.
Coded and entered daily invoices with in-house accounting software.
Trained and mentored administrative staff members in company policies, daily task execution and industry best practices.
Automated office operations for managing client correspondence, payment schedules and data communications.
Interpreted and communicated work procedures and company policies to staff.
Resolved customer inquiries and complaints requiring management-level escalation.
Provided leadership, insight and mentoring to newly hired employees to supply knowledge of various company programs.
Interviewed prospective employees and provided input to HR on hiring decisions.
Assigned work and monitored performance of project personnel.
Produced thorough, accurate and timely reports of project activities.
Mediated conflicts between employees and facilitated effective resolutions to disputes.
Proposed or approved modifications to project plans.
Created and managed budgets for travel, training and teambuilding activities.
10/2020 to 03/2021Benefits Verification SpecialistKite Pharma, Inc. | California, MD,
Coordinated benefits processing, including enrollments, terminations and claims.
Kept operations in compliance with requirements by applying knowledge of applicable regulations, legal statutes and tax code information.
Checked accuracy and completeness of benefits applications and documents.
Provided assistance to plan participants by explaining benefits information to ensure educated selections.
Mastered state and Federal benefit laws Including ERISA, FMLA, COBRA, HIPPA and 401k administration.
Performed in-depth investigations into personal backgrounds of applicants.
Prepared flow charts and career path reports to summarize job analysis and evaluation and compensation analysis information.
08/2019 to 09/2020Reimbursement SpecialistAdvance Auto Parts | Battle Creek, MI,
Determined medical necessity, using individual insurance carrier regulations.
Advised supervisors and clinicians of billing deficiencies to support charge capture.
Enforced adherence to MS and federal reporting regulations by performing regular compliance audits.
Researched rejections, investigating problems to appeal claims.
Collected coinsurance and deductibles from patients for rendered services.
Coded patient care records to provide accurate information for billing.
Worked with billing department to reduce contract implementation errors.
Enforced compliance with organizational policies and federal requirements regarding confidentiality.
Reconciled financial accounts using ICANOTES software.
Submitted claims to insurance companies.
Collected, posted and managed patient account payments.
Entered procedure codes, diagnosis codes and patient information into billing software to facilitate invoicing and account management.
Checked claims coding for accuracy with ICD-10 standards.
Trained new team members on company policies and accounting systems to keep team operations productive and efficient.
05/2018 to 07/2019Reimbursement AnalystHealth Care Service Corporation | City, STATE,
Reviewed uninsured accounts, verifying medical assistance application process, charity care application and drug replacement program availability.
Coded patient care records to provide accurate information for billing.
Researched rejections, investigating problems to appeal claims.
Transcribed data to worksheets and entered data into computer to prepare documents and adjust accounts.
Modified and updated existing policies and claims to reflect change in beneficiary, amount of coverage or type of insurance.
Performed detailed medical reviews of prior authorization request, following established criteria and protocols.
Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients.
Provided accurate information to all parties, including patients, insurance providers, healthcare staff and office personnel by using effective written and verbal communication skills.
Contacted insurance companies to obtain necessary preauthorizations needed for upcoming tests and procedures.
Determined which party would be liable for payment on medical services by thoroughly reviewing patient insurance coverage.
Education and Training
Expected in 12/2023 to to MBA | LeadershipBelhaven University, Jackson, MSGPA:
Expected in 12/2018 to to BBA | Finance Jackson State University, Jackson, MSGPA:
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