Database Analyst
CurrentSupported various authorization log reports for each health plan/carrier involving the approval/denial of medical claims, both commercial and Medicare lines of business. Each health plan/carrier requests their own specific template guidelines be met with accurate results (data types, column order, value formats, etc). Monthly eligibility routine inloads into each database system for new health plan members, reinstatements, updates, terminations. Monthly routine pharmacy patient data inloads into each database system for HEDIS / P4P reporting. Various on-demand adhoc reports including mailing lists, open authorizations & referrals for specific providers for Health Services Dept. Oversee Monument Systems Xpress v 3.10 (legacy) to Plexis Quantum Choice 2015 database system transition.