Bryant Wright Email & Phone Number

Bangalore, Karnataka, IN

Cambridge, MA, US

-insurance claims systems implementation, managed care/health plans, and new product/benefits plan implementation in an operations capacity. - Handle health Plan industry such as, claims processing, benefits configuration, member enrollment, correspondence, experience in business consulting/product implementation/business analysis. - Responsible for.

US

• Maximize savings through expansion of new or existing programs across lines of business, platforms, and operational programs
• Accountable for monitoring savings and identifying opportunities. Monitor technical issues and drive to resolution in conjunction with matrix partners
• Monitors project progress by tracking activity, resolving problems, publishing progress reports and recommending actions.
• Prepares technical reports by collecting, analyzing, and summarizing data and trends.
• Reviews facility claim data to identify reimbursement rates and trends

• Perform development activities from gathering requirements and designing solutions, through developing code / reports, to testing and release / deployment.
• Develop and analyzes business performance reports (e.g. for claims data, provider data, utilization data) and provides notations of performance deviations and anomalies.
• Create and publish periodic reports, as well as ad hoc reports. Taking business issue and devising best way to develop appropriate diagnostic and/or tracking data that translates business requirements into usable.
• Serve as a primary point of contact for Production Support issue resolution

Atlanta, GA, US

• Experience gathering and converting data into written narratives that is used for updating benefit implementation project stakeholders and to make recommendations on benefit configuration system changes needed.
• Hands-on experience with rules based table driven claims and eligibility administration systems claims processing systems).
• Proficiency in medical terminology, medical coding (CPT Codes, ICD9/10, and HCPCS), provider contract concepts and common claims processing/resolution practices.
• Analyze explanation of coverage documents to assist with determining best approach for loading benefits offered including member cost share and out-of-pocket maximums.
• Identify ways to enhance performance management and operational reports related to new business implementation processes.
• Aid in the creation of test scripts, including regression testing cases, to validate system configuration against source documentation.

Detroit, Michigan, US

• Conducted an application conversion and implementation from FEP Mainframe to NASCO web based claims processing system
• Experienced knowledge of medical terminology and claims coding including ICD-9/ICD-10, CPT, Revenue and HCPCS codes, CM1500 forms and UB92 forms
• Post and reconcile insurance and patient payments. Research and resolve incorrect payments, EOB rejections, and other issues with outstanding accounts
• Insure accuracy of insurance claims. Verify correct ICD-9 and CPT codes for a variety of specialties
• Processed patient's billing, statements, reimbursement claims, post transaction and data
• Provided general business analysis to supply responses to customers and provider inquires received via telephone, correspondence or in person; involving a variety of complex claim/benefit issues related to various.

Master Of Business Administration (Mba), Strategic Management

Bachelor Of Business Administration (Bba), Business Administration And Management, General