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Sr Contract Analyst Resume Example

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Jessica Claire
, , 100 Montgomery St. 10th Floor
Home: (555) 432-1000 - Cell: - resumesample@example.com - -
Website, Portfolio, Profiles
  • www.Studio1987.co
Professional Summary

Creative Operations Specialist skillful in executing effective operating rhythms and management systems structures. Expertise in analyzing, articulating and solving various problems. Analytical and organized professional comfortable working independently or as part of team.

Skills
  • French - Intermediate
  • Proficient in following: WORD, EXCEL, Adobe Acrobat, MAC OS X; SPSS, NAVINET, EMDEON, SQL data query
  • FACETS, EXP MACESS, CITRIX, ARUGS, Rebate Data Management, Rebate contract analytics
  • Statistic analysis
  • Interpersonal Communication
  • Creative Thinking
  • Adobe Creative Suite
Work History
01/2021 to Current
Sr Contract Analyst Roper St. Francis Health Care Johns Island, SC,
  • Oversaw 4 analysts spread under 3 varying contracts
  • Communicated price protection variances with managed accounts.
  • Coordinated monthly client calls to monitor clientele/ business health
  • Maintained average of 99.8% or above payment timeliness and accuracy to client accounts.
  • Evaluated diverse organizational systems to identify workflow, communication and resource utilization issues.
03/2019 to 01/2021
Contract Analyst Community Health System Foley, AL,
  • Managed 10 pharmaceutical accounts ensuring timely receipt of managed market rebates.
  • Analyzed invoices for accuracy regarding unit & pricing.
  • Communicated price protection variances with managed accounts.
  • Coordinated monthly client calls.
  • Maintained average of 99.3% or above payment timeliness and accuracy to client accounts.
  • Analyzed contractual amendments and inflation agreements regarding rebate changes or price protection/WAC changes.
  • Monitored all incoming contracts and service agreements for correct pricing and information.
  • Coordinated changes to agreement which might occur during contract lifetime.
01/2014 to 03/2019
RESEARCH ANALYST Arrive Logistics Austin, TX,
  • Functioned as technical specialist for claim enhancements operations while analyzing complex operational claim payment issues.
  • Identified areas where changes to existing processes reduced ineffective time management by 25%.
  • Decreased error in payment of contracted hospital claims of 100k or more.
  • Identified errors regarding state encountered claims.
  • Analyzed statistical data using both modern and traditional methods.
  • Validated incoming data to check information accuracy and integrity while independently locating and correcting concerns.
07/2013 to 01/2014
PROVIDER CLAIMS SERVICES REPRESENTATIVE Charles River Community Health Waltham, MA,
  • Monitored outstanding inquires and resolved areas of non-compliance.
  • Excelled as subject matter expert on updated rules and regulations from CMS.
  • Detected discrepancies for further suspension of claims, requiring special handling.
  • Responded proactively and positively to rapid change.
  • Promptly responded to inquiries and requests from MD offices & hospitals.
01/2012 to 07/2013
PHARMACY INSURANCE COMPLIANCE LEAD ANALYST CIGNA-HEALTHSPRING City, STATE,
  • Assisted physicians and pharmacies in Medicare claim processing, including pharmaceutical appeals and prior authorizations.
  • Maintained electronic service log(s) on physician calls and follow-up history.
  • Trained new hires on standards of procedures.
  • Initiated project to expedite coverage determination on first-time filled patients.
  • Participated in internal audits regarding quality management system.
  • Liaised with risk management, internal audit and employee services departments to direct compliance issues to appropriate channels for investigation and resolution.
  • Developed and updated policies and procedures, maintaining compliance with statutory, regulatory and local, state and federal guidelines relating to HIPAA, benefits administration and general liability.
09/2010 to 01/2012
PHARMACY TECHNICIAN CVS CAREMARK City, STATE,
  • Assisted pharmacist on mixing and dispensing of prescription drugs.
  • Communicated with patients to collect information about prescriptions and medical conditions or arrange consultations with pharmacists.
  • Restocked pharmacy shelves with current merchandise to drive consistent peripheral sales.
  • Counted, measured, and compounded medications following standard procedures.
  • Communicated instructions to patients or caregivers about proper use and storage of drugs.
  • Located and measured medications according to prescription information, making modifications as instructed by pharmacists and providers.
  • Ordered medicines daily to replenish stock and increase inventory in anticipation of need.
Education
Expected in 05/2015
Master of Arts: MARRIAGE AND FAMILY THERAPY, HUMAN COUNSELING
Liberty University - Lynchburg, VA
GPA:
Expected in 12/2009
Bachelor of Arts: PSYCHOLOGY
University of North Carolina At Charlotte - Charlotte, NC
GPA:
PHOTOGRAPHY

I have been a photographer for over 4 years, starting in film and moving onto digital format. As of May 2021 I have my LLC for my photography Studio 1987. I have been self taught with both my photography concepts and learning to retouch in Photoshop, now learning in Capture One.

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Resume Overview

School Attended
  • Liberty University
  • University of North Carolina At Charlotte
Job Titles Held:
  • Sr Contract Analyst
  • Contract Analyst
  • RESEARCH ANALYST
  • PROVIDER CLAIMS SERVICES REPRESENTATIVE
  • PHARMACY INSURANCE COMPLIANCE LEAD ANALYST
  • PHARMACY TECHNICIAN
Degrees
  • Master of Arts
  • Bachelor of Arts

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