Lisa Longfellow Email & Phone Number

Pittsburgh, Pennsylvania

Responsible for recurring Provider data analysis / reports using Microsoft Access and Microsoft Excel. Responsible for the daily interface of provider data to the claim production system including evaluation of error records. Geographical access analysis using the Geo Networks software. Create and maintain departmental process and procedure documentation..

Greater Pittsburgh Area

This was initially a six-month contract at Highmark. I was responsible for business requirement gathering and creating a test plan using the Rational Unified Process (RUP). In this role, I had to quickly gain an understanding of the business needs for an Automated Document Factory. All work was contingent on a specified release timeline. Excellent problem.

Greater Pittsburgh Area

I was hired under a six-month contract through Sapphire Technologies April 2010. In August 2010, I became a regular full-time PNC employee. I was responsible for creating Professional and Institutional Business Rules in the ILOG BRMS (Business Rule Management) software. These business rules would ensure the customer a smooth submission of electronic, 837.

Greater Pittsburgh Area

I was promoted multiple times during my career at Coventry Healthcare. In the IDX System, I processed, adjusted and performed high-level quality review of difficult and sensitive Medicare and Commercial claims. This included benefit interpretation, provider contract review, and system data mine via a data warehouse query for possible claim overpayments.