Darryl Watkins Email & Phone Number

Camp Hill, Pennsylvania, United States

Provide Analytical support for Claims Operations. Manage daily pended claims inventory.Insure adjudication timeliness to satisfy regulatory compliance metrics. Implement and manage payment integrity in regards to overpayment identification and recovery.Oversight on encounters accuracy and rejections scrubs clean up efforts.Manage a team of business.

Camp Hill, Pennsylvania, United States

Engages directly with Claims Director and Senior Manager producing analytics for recovery efforts around claims payment integrity and coordination of benefits.Queries developed responsible for recouping $1 million in overpayments and have eliminated an average of $4,333 per month in sanctions, to date.Provides daily and weekly analytics updates on claims.

Harrisburg, Pennsylvania Area

SQL Server 2008 R2 reporting in SSRS. Leverages partner Cognos web-based reporting tool for advanced analytics of Pharmacy Utilization by members.

Buffalo/Niagara, New York Area

Client: Fidelis of NY... Senior SQL Developer on team responsible for ACA Healthcare Exchange for the State of New York business process integration with FACETS. Meets with stakeholders and business analysts for process design solutions for FACETS Customer Service Inquiry (CSI) interface customized solutions. Meets with stakeholders for requirements.

Harrisburg, Pennsylvania Area

Served as a tester on the development of updated Davis Vision dot com website/web portal. Started by revising As-Is/To-Be requirements for the new site loaded into Microsoft TFS (Team Foundation Server). Filled the QA role on Scrum team in Agile Development environment responsible for overhaul of Member Portal. Revised As-Is/To-Be requirements to assure.

Camp Hill, PA

Serving as Sr. Business Analyst in support of QualityBLUE Provider Performance Assessment Web Application delivered by Truven Health (f.k.a. Thomson-Reuters). Developing test cases to validate application data is consistent with claims, membership and provider data in Highmark's Enterprise Data Warehouse. Using data analysis and presentation to influence.

• DNJ Solutions, LLC is an IT Consulting/Outsourcing firm with an emphasis on Business Analysis, Data Analytics and Systems Testing and Integration. We provide access to more streamlined and targeted business processes.
• Identify an organization’s business needs by asking the right questions.
• Making the right talent accessible to an organization to analyze business goals and objectives. This step can include implementing a team of Business and Data Analysts to determine the organization’s technology gaps.
• Advise decision-makers on which tools will drive the organization toward achieving their goals.
• Install a team of developers and testers to interpret the business need into a business process that directly reflects the goals of the organization. This step can include following new systems integration from design.
• Applications Development

Harrisburg, Pennsylvania Area

Consulted with PA Department of Revenue on testing Modernized e-File system implemented by Revenue Solutions, Inc. Managed inventory of business-use test cases for personal and corporate tax systems. Developed a dashboard to communicate testing status and completion rates to client. Served as liaison between staff testers and developers to effectively.

Served as primary consulting contact for Capital Blue Cross' annual Healthcare Effectiveness and Data Information Sets (HEDIS) audit conducted by NCQA. Key in providing statistics for categorical utilization data to determine if client met quality care standards in order to service Medicare/Medicaid coverage. Achieved low percentage of errant reporting by.

Solely responsible for the conversion and automation of all military contract utilization and metric performance production reports. Improving report generation process to one stop/one step cut department cost allotted for data retrieval by 20%. Was able to provide accurate reporting and exceed deadline expectations by achieving the following: Constructed.

Served as key contact for Administrative Services Only (ASO) customers to receive weekly and monthly financial reports. Business Process Improvement resulted in eliminating monthly data extraction costs from department expenses. Maintained rapport with external customers to increase client service value. Supported customer claims reimbursement transactions.

Solely responsible for supplying customer account experience (claims, premium and membership) data to Underwriting Department for the purpose of generating renewal rates. Generated application which automated the process of extracting and reporting experience data for accounts that are up for renewal, in addition to calculating renewal rates based off of.

Provide technical support to consumers with ADSL / Cable Broadband ServiceWalk customers through basic troubleshooting.Hardcode TCP/IP configurations across multiple operating system platforms.Uninstall and reinstall communication components for multiple operating systems.

Devised a UML schema for modifying existing tables and developing new tables for the Department's reporting tool. As a result, more efficient queries could be run and return accurate and complete records.Designed and developed database reporting utility that allowed for the exportation of graphical reports to MS Word using OLE Automation, VBA, Access.

Updated and maintained the online FAQ of the company's top-selling ActiveX control (TrueDB Grid). Software samples were developed using COM objects with company products to provide "Tips and Tricks" for customers. Developed database front-end applications (VB6, ADO, TrueDB Grid and MS Access) to track and update online knowledgebase.Generated tutorials for.

Facilitate usage of software programs (MS Visual Studio 6, MS Office 2000, Mulberry, and Windows 98b).Involved in setup and networking of computers.Troubleshoot user and equipment errors.

Bs, Computer Science

Activities and Societies: Order of Omega, Alpha Phi Alpha Fraternity, Inc., Men's Bible Study, Some of God's Children Gospel ChoirReceived.

Education record