Business Analyst III @ Horizon Blue Cross Blue Shield of New Jersey
Business System Analyst @ Healthation
Health Management Professional with over 10 years of diverse insurance experiene. My Experience includes Process Improvement, Change Management, Membership, Billing and Enrollment and claims with various lines of business. Creating Customer Work Orders in SalesForce for system enhancements Create BRD's and TRD’s, collaborate with IT leaders to ensure the delivery of high quality business requirements. Initiating and
Health Management Professional with over 10 years of diverse insurance experiene. My Experience includes Process Improvement, Change Management, Membership, Billing and Enrollment and claims with various lines of business. Creating Customer Work Orders in SalesForce for system enhancements Create BRD's and TRD’s, collaborate with IT leaders to ensure the delivery of high quality business requirements. Initiating and managing project timelines for new business and renewals with external Fully Insured and ASO customers. A skillful analyst with strong conceptual skills that demonstrates ability to solve and mitigate complex systems, processes and problems; executes projects to ensure details are not overlooked.
Project Business Analyst @ Conduct root cause analysis on system issues and fixes derived from enrollment and billing. Report Analysis to the Reliability committee for to assign IT resources and resolution. Lead and outline new Projects and UAT initiatives, accountable for assigned departmental deliverables and completion dates Define business and functional requirements, test plans, test cases and test scripts Extract data from data warehouse tables to create reports for departmental reconciliation processes Create current and future Visio process flows for departmental documentation Lead Billing and Enrollment User Acceptance Testing (UAT) for projects, implementations, system fixes and enhancements. Review technical specifications to ensure department business requirements are adequately reflected in technical planning documents and projects From March 2014 to December 2014 (10 months) Greater New York City AreaBusiness Analyst III @ Identify and communicate business needs to support regulatory requirements for Healthcare Reform regulation within the context of the 2014 Operating Model. Creating Visio process flows and desk level procedures to capture the new Exchange business for the use of testing and training. Establish a framework for process assessment, transformation and continual change management. Conduct interviews to extract process knowledge from membership, billing and enrollment stakeholders to translate into process maps and detailed training materials that capture step-by-step activities required by each team and role to complete each process. Design and document workflows, make recommendations that will positively impact operational effectiveness for the Exchange markets. Creation of an Exchange member on-boarding/welcome packet to support enrollment and fulfillment. Share Best Practices and work to develop junior team members in process improvement skills. Participated in business scenarios and gaps documentation sessions with NASCO to capture system enhancements for the Exchange program. Partner with the User Acceptance Testing team (UAT) for projects, implementations, system fixes and enhancements. Create the BRD and TRD’s, collaborate with business and IT leaders to ensure the delivery of high quality business requirements. Create, deliver and execute initiatives that improve implementation during open enrollment. Support and implement initiatives related to mandates: Health Care Reform, Minimum Standards, and mandated ID card changes. From March 2011 to January 2014 (2 years 11 months) Newark, NJBusiness System Analyst @ Provided consultative services to a range of healthcare professionals on company’s payment processes, system requirements and other related issues. Involved in the implementation of a custom web-based benefits management and claims payer system within all lines of business in the healthcare industry. Performed gap analysis and closed gaps in current and future application enhancements. Testing of claims to insure products was configured correctly Run SQL queries in access for each product. Researched and resolved systems configuration questions from the internal project teams and the client. Became a Subject Matter Expert in the finance, benefit building and code limitations functional areas. Used Sales Force to write customer work orders for system errors. Worked with software engineers on the creation of technical specifications and system upgrades. Created use-case scenarios to support application enhancements. Analyzed the clients’ requirements to specify user interface design, field level functionality and mapping documentation within the software design life cycle (SDLC). Configured auto lockbox file feeds into application environment to process cash receipts batches. Defined and documented requirements to assist in the development of software specification. From October 2008 to June 2010 (1 year 9 months) Lisle, ILImplementation Project Manager @ Managed new business and renewals for key accounts. Initiated and managed project timelines and regular internal & external status calls with participating teams. Completed business readiness checks on structured lines of business. Orchestrated all activities required to properly install businesses on to all UHG systems. Collected and interpreted data for loading and traceability purposes. Collaborated with strategic account executives, account managers and underwriting to provide effective benefit consultation for plan revisions, managed care strategies, product development, policy and procedures changes, legislative change and claim cost control. Served as a Benefit Configuration Expert. From January 2007 to August 2008 (1 year 8 months) Chicago, IL
Bachelor of Business Administration (B.B.A.), Business Administration and Management, General @ University of Phoenix From 2008 to 2010 Marcus Boyd is skilled in: Business Requirements, Requirements Gathering, Business Analysis, SDLC, Insurance, Health Insurance, Visio, Requirements Analysis, User Acceptance Testing, Process Improvement, Claim, Medicare, Vendor Management, Business Process..., Data Warehousing, Business Intelligence, Access, PMO, SharePoint, Data Analysis
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