Deborah Brown
Business Analyst
Ocala,Fl
Summary
Accomplished Business Analyst with a proven track record in business process improvement and cost-benefit analysis, notably with Cigna Healthcare.
Expert in leveraging data visualization and decision-making skills to drive operational efficiencies, achieving significant cost reductions.
Seasoned Business Intelligence Analyst with background in converting complex data into actionable insights to drive decision-making processes. Skilled in analyzing trends, crafting detailed reports, and enhancing business operations through technology solutions. Demonstrated ability to work collaboratively across teams to implement improvements, leading to increased efficiency and productivity.
Overview
18
18
years of professional experience
Work History
Business Analyst II
Contracted with Medasource Agency for HCA
Louisville, KY
09.2024 - 01.2025
- Ensured contract amendments and updates with timely ACF submissions.
- Streamlined the contract request process by compiling critical provider details such as NPI number, employment type, rate, and specialty.
- Communicated pertinent data to service providers and clinicians, enhancing contract revision procedures.
- Initiated the process for requesting new or amended contracts for providers by gathering essential information such as NPI number, employment type, rate, and specialty.
- Collected and organized provider information including NPI number, employment type, rate, and specialty to facilitate new or amended contract requests.
Provider Team Lead Analyst
Cigna Healthcare -Provider Data Management
Baltimore, MD
07.2014 - 02.2024
- Worked directly with the Data Engineers, Network managers, Provider Contracting Managers within the market, and Contract Engineers to ensure network accuracy based on maintenance fallout and market intakes
- Responsible for importing, extracting, and transferring large amounts of data from a homogeneous data source metric warehouse; storing it in proper format or structure for querying purposes.
- Performs uploads and edits for Medicare provider contracts, 101 claims, and networks by using business rules and processing provider data information records by loading front end and back end in support of claims adjudications in the QNXT Trizetto system.
- Configuration of CCR contracts and MAS – conducted QA testing in UAT for CCR production validation.
- Performed the transfer and migration of CKIT to the KnowledgeXChange system as a Licensing Knowledge Author. Responsibilities include being the Lead SME for the Provider Wizard Database, providing guidance, coaching, and direction to more junior team members, and acting independently while working under limited supervision.
Healthcare Data Processor Analyst
Robert Half International Inc.
Baltimore, MD
03.2013 - 09.2013
- Analyzing, investigating, and processing Medical Data Information Modules that are downloaded from the Hospital Patient Accounting Revenue Cycle.
- Process data exchange billing information before submitting electronic claims back through the Clearinghouse Transmittal System for electronic remittance advice. Once tracking, processing, and test runs are done for data reports errors in the GE/IDX-Centricity system, then the reporting phase can start.
Healthcare Data Manual Analysis and Data Error Pro
Ameritox, LTD
Baltimore, MD
01.2010 - 12.2012
- Worked as a Call Center Representative and Data Error Processor to adjudicate the following medical claims forms 835/837/834/270/271/277 (X12 Standards) through the Clearinghouse Transmittal System so claims could be paid out.
- Also, pre-coding requisitions, using ICD-9 and ICD-10, CPT, and HCPCS coding, so that customers could be seen by their primary physicians.
Recovery Specialist
Coventry Healthcare
Baltimore, MD
05.2009 - 11.2009
- Investigate and recover refund payments, correct data information from each hospital patient accounting using revenue cycle components such as registrations and demographic errors, charge entry errors, patient billing, cash entry, bad debt and collections, electronic remittance, eligibility verification, and accounts receivables through the GE/IDX-Centricity system, and retest claims that did not submit correctly through workflow and Clearinghouse transmittal.
Financial Consultant Implementation Analyst, & Hel
Keane Healthcare Professional Services of LTC
Baltimore, MD
07.2007 - 01.2009
- Achieved Financial and Operational Strategic Planning objectives to the Stakeholders by contributing information and recommendations reviews by preparing and completing action plans; implementing production, productivity, quality, and customer-service standards
- Resolving problems: completing audits, identifying trends, implementing changes, enhancing, and determining system improvements effectively to reduce the total health care cost in the first year of Implementation
- Business Analysis: Wrote Business Requirements, Functional Requirements, Use Cases, and Test Scenarios.
- Used Visio to create use case diagrams and test cases for testing the functional requirements. Implemented automated COB processing of Medicare claims into Facets. As a Quality Assurance Tester, provided accurate, timely, detailed case notes when routing cases to appropriate queues to facilitate case support, and coordinated and supported IT techs and programmers during SQL edit checks and bug testing.
- SELECT statements for data verification, design, development, and maintenance/enhancement of manual and automated test cases.
- Experience in defect reporting and tracking, involved in writing and executing test cases, and development of specification documents used by different groups during the configuration of Clinical Medical Billing software applications product.
- IT Helpdesk Support Tech Function Summary: Worked with IT programmers and vendors, such as Central Labs and Clinic, to ensure that all back-end clinical practices management, configuration, loading, extracting, and importing ICD-9, CPT, and HCPC code libraries.
- Administrator licensing and updating Case User changes and supporting line-of-business software, including support of Windows 2000/2003 server technology, Active Directory, DNS, SQL Server, and Terminal Server in a multisite environment, and other duties as assigned.
- Experience: in using various remote desktop IP address connections, Cisco Pix, Microsoft VPN, LogMeIn remote, GTE Gateway connection, NetMeeting, Citrix ICA Workflow App, GE/IDX Managed Care App.
- V9.0, one-source, RAM, and BAM app.
Education
Graduate Certificate - Information Technology Security And Administration
MyComputerCareer InformationTechnology
Charlotte, NC06-2020
Certificate - Business Analytics
Universal Technology Ctr
Baltimore, MD08-2013
Skills
- Predictive modeling
- Gap analysis
- Business process improvement
- Cost-benefit analysis
- Business solutions development
- Product development
- Decision-making
- Operations analysis
- Workflow optimization
- Data analysis
- Technology architecture analysis
- Information modeling
- Business process mapping
- Data visualization
Timeline
Business Analyst II
Contracted with Medasource Agency for HCA
09.2024 - 01.2025
Provider Team Lead Analyst
Cigna Healthcare -Provider Data Management
07.2014 - 02.2024
Healthcare Data Processor Analyst
Robert Half International Inc.
03.2013 - 09.2013
Healthcare Data Manual Analysis and Data Error Pro
Ameritox, LTD
01.2010 - 12.2012
Recovery Specialist
Coventry Healthcare
05.2009 - 11.2009
Financial Consultant Implementation Analyst, & Hel
Keane Healthcare Professional Services of LTC
07.2007 - 01.2009
Graduate Certificate - Information Technology Security And Administration
MyComputerCareer InformationTechnology
Certificate - Business Analytics
Universal Technology Ctr
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