Lead Business Analyst

Collaborated with stakeholders to identify business needs, document requirements, and translate them into functional specifications. Supported data analysis and reporting to inform decision-making and monitor KPIs.

Mapped EDI requirements and specifications for healthcare transactions including 837, 834, 835, and 270/271, as well as Medicare Part A, B, C, D, and Medicare Advantage plans. Assisted with solution design, testing, deployment, and implementation of technology solutions.

Analyzed business processes, gathered and documented requirements, and partnered with stakeholders, business units, and IT teams to improve operational efficiency. Identified workflow inefficiencies and recommended process improvements to improve productivity and reduce costs.

Performed EDI mapping for 837, 834, 835, and 270/271 transactions and Medicare plans. Supported data reporting, solution design, implementation, change management, testing, deployment, and project planning as a Scrum Master.

Supported software systems for electronic exchange of healthcare data between providers, insurers, and payers. Managed claims submission validation, coding checks, HIPAA compliance, claims status tracking, and error resolution using clearinghouse processes.

Worked with ANSI X12 EDI standards and healthcare transactions including 837 and 835. Produced claim status, remittance advice, and payment tracking reports, supported HEDIS quality analysis, and helped integrate clearinghouse systems with EHR and practice management software.

Led end-to-end implementation of Laboratory Information System applications, including setup, configuration, customization, and requirements analysis for laboratory workflows. Translated business requirements into technical specifications for LIS configuration.

Managed data migration and integration with healthcare systems, conducted user training and ongoing support, and performed functional, integration, and user acceptance testing. Created implementation documentation, user manuals, project plans, and post-implementation reports.

Managed outsourced healthcare business processes involving Medicare, Medicare Advantage, and Medicaid claims. Oversaw claims processing, data entry, adjudication, payer communication, eligibility verification, enrollment, medical coding, billing, and revenue cycle activities.

Ensured compliance with CMS, HIPAA, HITECH, and payer requirements while supporting reporting, process optimization, customer service, denial management, and accounts receivable. Also contributed to pharmaceutical sales and marketing through sales strategy, product promotion, market analysis, CRM, brand positioning, regulatory compliance, and sales training.

Worked as a Business Manager in the ADD division of Orchid Pharmaceuticals.

Supported pharmaceutical business management and sales operations.

Served as District Sales Manager for Sigma Laboratories Ltd., presently referenced as Swizere Ltd., a division of Maneesh Pharmaceuticals.

Managed pharmaceutical sales activities and customer relationships within the assigned district.

JOC vocational education focused on computer science and database management.

Diploma program in pharmaceutical sciences.