Health Care Service Analyst Resume Example KAISER FOUNDATION HEALTH PLAN

HEALTH CARE SERVICE ANALYST

Experience

Health Care Service Analyst, 04/2014 to Current
KAISER FOUNDATION HEALTH PLAN – Fulton, MD

Use PMPM calculation method to ensure company wasn't paying excess in health insurance Creating SQL queries and scripts to extract and aggregate data to validate the accuracy data.
Collect and process the information needed to fulfill medical insurance claims and resolve billing issues that has to do with the account payable.
Assist in resolving Medicare CMS complaint file to the organization Defining problems, developing business models and highlighting an area for improvement, such as operating costs and budget.
Review, Interpret, & analysis collected data using different tools such as, MS Excel and data management systems to provide accurate & reliable reports to the company.
Support, manage, and maintain organizations Medicare clinical data Use EPIC system to analyze and assess Medical claims, Medical Billing & payments information Use of VLOOKUP, pivot table and Cloud based systems in presenting company achievement Develop business models based on the results of the data collected and analyzed.
Work closely with compliance and training department to ensure company keeps its Medicare 5-star rating.
Investigate pending claims and resolve discrepancies for physician's offices, and hospital billing departments.

Business Analyst, 05/2012 to 04/2014
AKAL SECURITY, INC – Baltimore, MD

Responsible for analyzing data as a part of the corrective action program.
Prepare annual financial information binder to be provided to the external auditors Review completed Corrective actions and Ace Investigations and make determination as to whether they were closed properly or not Ad-hoc reporting and querying for the staff data requests through SQL Server.
Clean and analyze the data received from condition reports and other sources and identify trends in the data.
Gathering, analyzing and interpreting business and financial information Determines the best metrics to use to provide the most accurate representation of the forecast Create visually appealing dashboards in Power BI from various data sources Make high level presentation to management on way of achieving business goals based on results of data analyzed Proficient with Power BI, MS Office and MS Excel skill.

Financial Analyst, 12/2010 to 05/2012
KC TAX & FINANCIAL CONSULTANT – Baltimore, MD

Direct all operational aspects including distribution operations, customer service, human resources, administration and financial report Prepare financial reports with reliable conclusions that management can use to implement more effective operational strategies Evaluate profit and cost efficiencies in various areas of the organization as needed Analyze trends in the market by mapping trends and determine how they will influence the business that consult with me.
Consolidating and analyzing financial data, considering company's goals and financial standing analyze organization by documenting the processes of assessing the business model with technology.
Manage forecast models, analyze trends, manage forecast tools, and maintain accurate data Routinely examine methodologies to find ways of improving predictive accuracy.
Develop and measure key performance indicators to track and evaluate forecasts made, to assist in assessing the effectiveness of the demand planning & forecasting function.
Ad-hoc data extraction through queries in SQL Server 2008, Excel, SAS,.

Financial Consultant & Analyst, 03/2008 to 09/2010
ZENITH BANK – NG

Monitor financial procedures and ensure compliance with the law Develop, maintain and distribute as-hoc reports and financial models as needed Track expenses and revenues vs.
budget and reforecast and analyze fluctuations Creates breakdowns and reports regarding client financial status Prepare monthly consolidation and executive financial package Develop, coordinate and implement marketing plans designed to maintain and increase existing business and capture new opportunities.
Performed capacity planning, Transforming & Loading data using SQL*Loader & External Tables Confer with management on demand planning and forecasting assumptions, analysis, and decisions.
Consult with management to guide and influence long term and strategic decision making within the broadest scope Track and determine financial status by analyzing actual results in comparison with forecasts.

Education

M.Sc: Business &Technology Management, Dec
Stevenson University
Business &Technology Management

BSC: Business Administration & Management, Dec 2017
Morgan state University
Business Administration & Management

Associates: EconomicsUniversity of Abuja, NG
Economics

Summary

A dynamic and resulted oriented professional, as a health care analyst, Forecasting, Management software, financial and business analyst with over six years of experience working in different domains. I also have extensive research experience, and have completed focus groups and business intelligence research that helped boost an organization's farebox recovery ratio by 15%. Additionally, I have strong analytical skills, and have used these skills to forecast possible future trends and address potential problem areas. Further, I have superior data visualization skills, and have translated data results into written reports, tables, graphs, and charts to convey information to management in past roles. I have also made presentations on ways to achieve company business goals based on results of data collected and analyzed.

Highlights

Microsoft Office Tools
Power BI
SQL
Excel
Microsoft Visio
Cloud Based System
Office 365
Linux Systems
Training and Professional Certifications
Linux Systems Administrator Intensive Training
VMware Install, Configure and Manage (In Progress)
Security+ in view
ITIL Certification in view
Project Management Professional(PMP) in view
Real Estate License in view
Certified Tax Professional 01-7135
Medical Terminology
STRENGTHS
Project Management
Budget planning & Allocation
Financial Reporting & System Development.
Business Case Development
Workforce Documentation & Optimization
Communication & forecasting

Skills

Ad, billing, binder, Budget planning, budget, Business Case, Develop business, developing business, BI, capacity planning, CMS, client, customer service, data management, decision making, Documentation, financial, analyzing financial data, financial report, Financial Reporting, Prepare financial reports, forecasting, human resources, insurance, ITIL, law, Linux, marketing plans, market, Medical Billing, Medical Terminology, MS Excel, Excel, Microsoft Office, MS Office, Office, Microsoft Visio, Optimization, pivot table, presenting, processes, profit, Progress, Project Management, Real Estate, reporting, SAS, scripts, SQL, SQL Server, SQL*Loader, strategic, Tables, Tax, view

Resume Overview

Companies Worked For:

KAISER FOUNDATION HEALTH PLAN
AKAL SECURITY, INC
KC TAX & FINANCIAL CONSULTANT
ZENITH BANK

School Attended

Stevenson University
Morgan state University
University of Abuja, NG

Job Titles Held:

Health Care Service Analyst
Business Analyst
Financial Analyst
Financial Consultant & Analyst

Degrees

M.Sc : Business &Technology Management , Dec
BSC : Business Administration & Management , Dec 2017
Associates : Economics

Health Care Service Analyst Resume Example

Resume Score: 90%

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