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Atlanta, GA 30303
Systems Analyst II
13 years experience W2
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Business Analyst that provides business solutions by designing, testing, and implementing new processes in areas of Member, Prior Approval, Provider and Claims Adjudication. Innovative leader with experience in conversions of systems and system migrations.

Systems Analyst II
Information Technology
Mar 2018 - present
Atlanta, GA
* Defines the functional, usability, reliability, performance and support requirements of the Interplan Teleprocessing Services (ITS/WGS) system, serves as a business subject matter expert, and acts as a liaison between the business and IT.
• Provides the link between the technical and the business views of the system by ensuring that the technical solutions being developed will satisfy the needs of the business.
• Leads system requirements definition, design, testing, training and implementation support.
• Applies use of tools such as JIRA and Sharepoint to define requirements and documentation.
• Implements agile projects for state mandates to include conducting daily stand-up calls.
• Provides analysis of efficiencies related to system enhancements/automation.
• Works with IT learning organization to assist in the development of system training documentation and provides training to end users.
• Assists with developing use cases.
• Facilitates calls with Business Partners, Vendor IT partners and Account Management when addressing escalations.
• Creates queries via Datanet in order to run macros against the data with a claims extractor tool to provide business with claims for reprocessing.
Agile Methodology JIRA System Analysis System Requirements
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Business Analyst III
Information Technology
Jan 2012 - Mar 2018
SME for Provider, Member, Prior Approval, Claims adjudication to include Medicare and TPL, Edits, Audits and Medicaid Policy
• Team Lead for all BA's on testing and other duties
• Serving as a Liaison between the client and HP with face to face support
• Held JAD sessions with IT, SME's, and TFALS for Requirements Gathering
• Create Process Maps and System Diagrams with input/output
• Held Clarifications meetings to clarify Change Orders for Implementation
• Provided QA to entire team on every phase of Implementation
• Completed Configurations for Provider Contract Billing Rules
• Completed Configurations for Edits and Audits
• Created Power Point Presentations
• Develop Test Plans and Testing in Medicaid Management Info System
• Provided training of new programs and processes to entire team on Provider
• Provided training on Provider Enrollment Processes
• Log any issues/defects encountered during test cycles
• Maintain and update traceability Matrix
• Defect tracking in documented repository
• Created Manuals for Claims and Appeals Department
• Attended Medicaid Fairs to provide assistance to Provider Community
• Drug Rebate Updates and configurations Tonya Eaves specialtye@gmail.com 919-602-1420
• Technical Experience as Liaison between client and engineers/developers
• Support the use of the SDLC Roadmap in the development of solutions and deliverables
Business Analysis Requirements Gathering
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Business Analyst II
Information Technology
Jan 2010 - Jan 2012
Implemented new services and programs via MMIS for the Medicaid program
• SME for Provider, Member, Prior Approval, Claims adjudication to include Medicare and TPL, Edits, Audits and Medicaid Policy
• Directly interfaced with the customer and the system engineers on a regular basis
• Gathered and documented business requirements
• Assisted in solution development and actively participated in validation and user acceptance testing solutions.
• Supported the use of the SDLC Roadmap in the development of solutions and deliverables
• Facilitated meetings with clients
• Gathered requirements
• Provided business operation expertise and support to the technical team
• Communicated project status and presented project deliverables
• Prepared change control request documentation to inform customer of budget changes, technical requirement updates, and confirmed approval
• Ensured the completeness, accuracy, and integrity of deliverables and project cost to clients
• Performed research using appropriate methods of approach and source materials and followed office procedures and norms
• Performed quality assurance activities including review of test cases
• Followed through with obtaining approval signoff on all assigned projects and provided post- implementation project support
Business Analysis
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Edit Skills
Non-cloudteam Skill
Healthcare Management
Southern New Hampshire University 2020
Middle Georgia State University
Information Technology courses
Strayer University
Administrative Office Technology
Virginia-Information Technology courses
Wayne Community College
Business Analysis
Requirements Gathering
Agile Methodology
System Analysis
System Requirements