Business Analyst
System Analyst & Business Analyst / Incepture Consultant for Blue Cross Blue Shield of Florida, Jacksonville, FL.Business Analyst for Service Organization and Eligibility Membership & Billing (EM&B). Researched and documented current & future state Service Organization and EM&B process flows to determine how to best integrate Siebel CRM into their business processes. Design, build, and load a new consolidated databases from databases to easily track eTool utilization & paperless invoice business practices resulting in improved comprehensive reporting and provide better decision making. Create prototype SQL queries for upper management reporting dashboards. Prioritize, Draft Business Requirement documentation for approval. Compiled Value Realization Plan (VRP - Six Sigma) for project funding and approval of Siebel CRM enhancements. Managed the PDSI migration of 105 users to Siebel CRM.System Analyst for the EDW (Enterprisewide Data Warehouse). Researched and sourced systems of record for many code sets, to include CPT4, ICD9, HCFA, DRG, and Sales Agent/Agency. Developed migration business rules, SQL code, and determined technical capability to migrate the source data to the EDW. Deliverables also included RUP documentation; Supplementary Specifications and Design Guidelines.Business Analyst for the Specialty Pharmacy Injectable project. Produced RUP 'Use Cases' utilizing Rapid Process Improvement sessions for review and approval. Researched and drafted; Problem Solving documents, Scope Documents, Business Vision Documents, and Value Realization Plan (VRP - Six Sigma) for project funding and approval. Researched and documented National Drug Code (NDC) data sources, process flow of claims, and target databases effected by the use of NDC's through out BCBSF. Researched and documented the use of NDC's in the 837 HIPAA Claims transaction and the 278 HIPAA Medical Clearance transaction through the Electronic Data Interfaces and claims processing engines.