Nathaniel Prophet Email & Phone Number

Columbia, South Carolina Area

• Serve as end user point of contact between System Security Officers and Technology Owners.
• Create and automate PPS discrepancy reports using Business Objects.
• Ensure that all Information Technology assets, (Computer workstations, servers, routers, web applications, database, operating systems, etc.) that are processing Centers for Medicare and Medicaid Services (CMS).
• Track and correct any applicable information security deficiencies, conditions, weaknesses, findings, and gaps identified by audits, reviews, security control assessments, and tests.
• Mitigate high risk discrepancies within 30 days and moderate-risk within 90 days from the date of identification to meet SLA guidelines and compliance.

Columbia, South Carolina

• Provide data warehousing support to Informatica developers.
• Provide Oracle SQL database maintenance and upgrades.
• Continuously manage and monitor scheduled extraction, transfer, and loading (ETL) of multiple 1-800-MEDICARE telecom source protected health information (PHI) data files into the Oracle data warehouse using UNIX and.
• Analyze and validate the source data files to ensure accuracy in accordance with the Centers for Medicare and Medicaid Services (CMS) standards.
• Work with development team to implement multiple complex Oracle SQL database and Informatica ETL workflow upgrades.
• Manipulate and create source data files in UNIX for manual ETL processing.

Columbia, South Carolina Area

• Promoted to System Support Administrator after implementing a process to improve communication, time, and accuracy when loading multiple source data files not received during a planned or unplanned outage.
• Manage and monitor the receipt, extraction, transfer, and loading of multiple 1-800-MEDICARE telecom source data files into the Oracle 11g data warehouse using Informatica Powercenter Manager 9.1/8.6 and Informatica.
• Analyze and validate the source data files to ensure accuracy in accordance with customer requirements.
• Import and export data files for manual processing and ad hoc testing.
• Manipulate, change, and create source data files for manual ETL processing.
• Document ETL loading success or failure in MS Sharepoint.

Columbia, South Carolina Area

• Successfully managed and completed multiple integration and regression testing projects.
• Executed different user acceptance testing (UAT) cases based on the Centers for Medicare and Medicaid Services change requests.
• Created and submitted test medical claims through PC-ACE Pro32 to determine correctness of new or updated Medicare Claims Systems or policy changes.
• Presented testing results to project lead, project team, and management.
• Ensured that all assigned projects are submitted accurately and timely.

Columbia, South Carolina Area

• Responded to telephone inquiries for 1-800-Medicare call center.
• Provided Medicare members with general Medicare information.
• Assisted in ordering Medicare cards and booklets.
• Guided Medicare members through the Medicare Prescription Drug Plan enrollment process.
• Trained new and current employees on updated policies and procedures.
• Monitored and tracked team performance using Microsoft Excel.

Columbia, South Carolina Area

• Responded to telephone inquiries for TRICARE for Life call center.
• Verified patient eligibility coverage with healthcare providers.
• Provided service to retired military beneficiaries through correspondence and telephone inquiries in reference to claims status and insurance record updates.
• Processed and adjusted Medicare supplemental medical claims for payment.
• Requested through written correspondence to Medicare participating health care providers and patients required documents to process and adjust medical claims.
• Trained new employees on Medicare supplemental claims processing and customer service procedures.

Master Of Business Administration (Mba), Project Management

Activities and Societies: Golden Key International Honors Society

Bachelor Of Business Administration (Bba), Marketing

Associate'S Degree, General Business

Activities and Societies: Phi Beta Lamda