Daniel Berning Email & Phone Number

Portland, Oregon Area

Portland, Or

Portland, Or

Responsible to work closely with a variety of business units to obtain the requirements and understand the information they seek, to propose reports that enable action to be taken by the business. Accountable for assessing new reporting needs to ensure that non-redundant, reliable, and accurate data is provided while conducting and continuously improving ongoing government and commercial programs to ensure their reliability, validity and integrity of the data used in management reporting and analysis. Write programs to routinely audit database reliability and validity to contribute to the maintenance of thorough and accurate documentation for end-user information, streamline production of management reports by writing or substantially revising programs developed to extract and produce necessary information, and edit, test, and put the programs into efficient production mode. Also develop tracking tools to log errors, requests for modifications, reporting schedule, performance guarantees, contract requirements, and other related activities associated with regularly scheduled reporting. Ensure that copies of programming code are kept updated in SAS or shared directories as appropriate. Assist with other Business Systems Analyst responsibilities to include defining business rules and processes applicable to the development and/or use of the applications, reporting tools, reports, and their presentation.Individually responsible for all data analysis and reporting to include monthly, quarterly, annual, and ad-hoc reporting for all government business and assigned commercial groups. Currently perform data trending for Medical, Vision, Dental, and Rx. Cost and Utilization, Benchmarking, Lag Triangles, Peer Reporting, PMPM Trending, Performance Guarantees, Stop loss, Management Reports, contract review, and contract input from a performance guarantee, reporting, and data requirements perspective.

Costa Mesa, Ca

Responsible for articulating TC3’s technology and product positioning to both business and technical prospective clients which includes actively driving and managing the technology evaluation stage of the pre-implementation final sales process. Participate as a key liaison between Sales Team, Account Management, Information Technology, Client Implementation and the client prior to contract execution and implementation as the key TC3 technical advisor and product advocate. Assist TC3 Sales and prospective clients by providing pre-sale services and technical implementation overviews, finalist presentations demonstrating savings and value proposition, preliminary EDI x12 837 and/or proprietary claims layout capabilities, preliminary desired EDI workflow(s), preliminary identification of custom requirements, TC3 required data validation with GAP analysis to provide a baseline to the client and TC3 Client Implementation Director and Project Management staff. Maintain client relationship through close in person and consistent contact with each client throughout the implementation process to ensure TC3 business services and technical solutions deliver measurable results and cost savings for both TC3 and the client. Utilize various data analysis tools to query, develop reports, and present the overall story represented through data to demonstrate overall savings realized by TC3 payer clients through claims payment reductions post-adjudication, pre-payment, to healthcare providers. Additional responsibilities include working with healthcare payer’s and TPA’s third party claims adjudication software vendors to elicit and solidify technical requirements resulting in a statement of work from the vendor.

Costa Mesa, Ca

Responsible for overall monitoring and 24/7 support of production EDI claims jobs, corrective action, and/or escalation processes for failures that occur in the transactional production environment to include Mercator/DataStage TX, stored procedures, Crystal Reports, SFTP/FTP, and encryption processes. Collaborate with users, both internal and external, in the development and delivery of new, ad hoc, and existing report enhancements as well as provide detailed savings projections for potential client via analysis of large sets of their medical claims data. Other responsibilities included internal financial reporting and presentation to CEO, COO, CIO, CSO, and Vice President of Sales which included client revenue optimization analysis, utilization analysis, estimated and actual savings to provide technical configuration recommendations and invoicing process improvement to increase revenue and make processes more efficient to ultimately improve the cash flow cycle. Individually designed and deployed internal Claims Management System used by Client Services department to track and monitor claim status. Lead a team of 3 developers through design, QA, and deployment of internal billing and invoicing system.

Senior Accountant for a company who led the industry in producing Technology Trade shows. Daily tasks included: maintenance of the Purchase Order system, preparation and posting of AP/AR, and maintenance of the General Ledger transactions, Budget vs. Actual reports, quarterly budget analysis, monthly balancing of the sub-ledgers to the general ledger, and assisting in the preparation of GAAP financial reporting including pre-paid accounts and month-end close.

Responsible for the management of corporate/small business benefit accounts. Daily tasks included billing, processing benefit payments, updating company accounts, assistance with financial reporting, generating deposits, and historical tracking and analysis. Key position in the finance department because of the large financial risk and responsibility.