Gilbert Ramirez Email & Phone Number

New York City Metropolitan Area

• Design, implement, and maintain Fraud and Abuse Management System (FAMS). Identify outliers/targets through FAMS and data mining.
• Extracting data using SQL in SAS to create and analyze reports to support investigators’ position in litigations and meetings.
• Perform conversion of various data formats from different sources to meet vendors’ specifications.
• Maintain and modify SIU Case Tracking Database for optimal performance. Manage, lead and resolve all IT/IS related projects and issues.
• Using business analysis techniques for the purpose of identifying solutions aimed at improving the efficiency and effectiveness of the system, business process, or product/service to fulfill the business requirements.

Greater New York City Area

• Business Information Analyst Sr. (Dept. of Medicine)
• Improvement of practices necessary to plan, design, initiate, and operate the information technology services offered staff and customers.
• Automating MS Access databases with VBA code by linking MS Access to other MS Office products to create GUI (graphic user Interface) to support staff and other department reports.
• Experience in MS Access SQL development - specifically using SQL specifically within MS Access to work with data.
• Simplifying steps by creating MS excel spreadsheets, MS Word documents and Outlook to email providers.
• Using SQL Assistant to analyze and interpret data; extract and manage large datasets, including ability to ensure the integrity of data.

New York, New York, United States

• Analyze medical data statistics and extract all aspects of data using SQL.
• Carefully examine, maintain, coordinate and share conclusions to improve current reports in Fraud and Abuse Management System (FAMS).
• Work with IBM on version upgrades, reports and maintaining the FAMS database.
• Support the corporate tech team in testing to implement the fraud and abuse medical system upgrades and new systems, by reviewing system capabilities, workflow and scheduling limitations.
• Analytics experience including report development and database application, in the healthcare environment.
• Support the Special Investigates by generating ad-hoc data reports.

New York, New York, United States

• Coordinate activities in electronic data processing of medical information, analysis medical provider submissions, and medical claims by building reports in Crystal Reports
• Exam and reorganize user requirements, procedures, and problems with existing system.
• Experience in analyzing existing SQL queries for performance improvements.
• Ensures quality and accurate development of reports based on knowledge of the system.
• Having Health insurance experience with understanding health insurance claim data and provider network data.

New York, New York, United States

• Automating MS Access databases with VBA logic to support staff.
• Designing, modifying and maintaining custom applications needed to ensure the database meets requirements for the corporate recovery department database to collect provider, subscriber, claim, billing information and.
• Developing and reconciling monthly reports for management and the department account.
• Experience in the identification of data quality.
• Experience in reviewing existing internal databases to determine improvements and implementing change for gaining efficiencies in daily operations.

New York City Metropolitan Area

Designs and writes custom applications needed to ensure the database meets requirements for the entry, management and reporting of data.Creating, modifying and maintaining databases and reports for the Coordination of Benefits (COB) department.Collect Hospital and Medical billing information and payments for the accounting department.Create reconcile.