Provided IT support to the Claims and underwriting departments. Projects were related to medical malpractice insurance and included making system changes that enhanced the 'user experience'. Responsibilities included:

• Meeting with key Business Stakeholders to gather Business Requirements related to the Web portal user experience.
• Documenting requirements and posting into the internal repository for access to the development staff.
• Holding meetings with both the development staff and the business stakeholders.
• Updating status related to sprint planning.
• Working with the SQA team to assist with testing and helping to develop training materials.
• Creating test plans and executing internal testing.
• Creating training documentation and working with the users during UAT testing to ensure the implemented change met expectations.

• Worked on gap analysis/research projects related to the Physical Therapy product line of business. Supported weekly production releases for the ‘Concierge’ referral system. This company was based on Workers’ Compensation Claimants needing care coordination

Responsibilities included:

• Working as a Business Analyst, writing business requirements, and supporting the QA testing team on CMS initiated projects for the Pharmacy and Wellness Group.
• Attending meetings with the Project Managers and Business to gather clear requirements.
• Documenting requirements and creating test plans.
• Running test plans and documenting results and any defects.

Responsibilities included:

• Working for the Business Connectivity Team (BCS) to implement changes to the inbound and Web order API services to support Breast Pump orders going into Brightree.
• Assisting in testing JSON and XML post/get transactions.
• Documenting WIKI pages with relevant information.

• Assisted the EDI team with HIPAA Operating Rules (HOpR) enhancements.
• Wrote test cases and executed testing for 270, 271, 276, and 277 rules. Documented system test results for delivery to the State.
• Worked with the Web team to implement provider enrollment, direct claim data entry, EFT, and ERA portal enhancements.
• Currently assisting with the Department of Labor ICD-10 project.
• Working with the SQA team to assist with testing, and helping to develop training materials.

• Acted as the subject matter expert for the Department of Labor Central Bill Process implementation.
• Assisted developers in the interpretation of legacy data and input into system design.
• Wrote business requirements and performed review of functional specifications.
• Attended JAD sessions with the DOL.
• In addition, attended meetings with the client on topics such as moving to BETOS, OPPS, and the development of an enhanced provider enrollment form.

• Working remotely from home, supported the Fiscal Agent staff (FAS) located in Tallahassee, FL. The FAS operations included claim processing/resolutions, call center, provider enrollment, and prior authorization for the Department of Labor.
• Helped to streamline manual processes and better use the claim processing system. Acted as a point of contact between the DOL client, operations, and the systems group. This also included the Pharmacy system.
• Ensured system enhancements were clearly communicated and the overall impact to the organization had been evaluated. Coordinated all file maintenance/configuration activities related to procedure file, fee schedule, and edits in the system.

• Served as the primary point of contact for the DOL project. Assisted the client with prioritizing and approving customer service requests (system enhancements). Attended on-site meetings and conducted training for both DOL and the Fiscal Agent when needed.
• Acted as a subject matter expert for others on the team. Answered technical questions and researched issues. Participated in the change control board meetings for software promotions to production. Reviewed acceptance test plans and results completed by other business analysts for final sign off. Attended technical design meetings to ensure business needs were met.
• Presented with a “Letter of Appreciation” from the U.S. Department of Labor Federal Black Lung program.

• Served as the lead business analyst for the DOL implementation that went live September 2003. Attended JAD sessions and wrote business requirements. Managed testing, defect tracking, and documentation for each release.
• Played a major role in system integration testing, which occurred with the client on-site. Spent several weeks at the DOL assisting the client with user acceptance testing. Provided systems support to the Fiscal Agent, and conducted training when the system went live.
• After implementation, continued to write business requirements and conduct testing for system enhancements.
• Built a strong trusting relationship with the DOL client.

• Participated on a regional project to implement eligibility standards across four sites.
• Provided national support and development of medical and dental systems.
• Coordinated updates to training materials, job descriptions, and intranet website.
• Upon Aetna purchase of Prudential, assisted in the data migration effort, with no interruption to client eligibility or claims processing.

• Supported a mainframe system reporting long distance data. Wrote business requirements and test plans for projects impacting downstream systems.
• Assisted in Y2K testing.
• Conducted audits and investigations into data integrity.
• Acted as a liaison between business groups and technical staff.

• Held several positions with Prudential over 10 years of employment including: dental claims examiner, property and casualty underwriter, client liaison, and business analyst.
• As a business analyst, worked with eligibility, claims systems, and billing processes. Acted as a liaison between national clients and programming staff.
• Partnered with Marketing/Sales in setting up new accounts.
• Worked on open enrollment and ID card production.
• Worked with outside vendors used by many of our clients (Hewitt, Towers Perrin, and Fidelity).
• Responsibility for eligibility of national accounts included: Suntrust, NationsBank, Worldspan, Disney, Circuit City, TBS, Auto Zone, Norrell, and Nortel.