Professional BackgroundHighly motivated professional seeking opportunity to obtain a challenging position with Florida Blue that will fully allow me to utilize my education, skills, loyalty and work ethics where initiative and accomplishments will be the basis for professional advancement and mutual growth. Technical SkillsMicrosoft Windows 8, Microsoft Word, Excel, Outlook, PowerPoint, Access.Provider Information Platform (PIP), Diamond DFS, Diamond Maintenance Tool PROD DFS (DMT), PFE, IMS, EVerify, FedEx shipping and tracking, UPS shipping and tracking.Siebel queue inventory management, and Client Letter.Experience in building and Maintaining strong business relationships.Experience with health care industry, business related process and delivery system.Strong written and verbal communication.speak and write both French and Creole.Critical thinking Education and TrainingBachelor of Science Health Service Administration,Expected in2014toUniversity of Central Florida-Orlando,FLGPA Health Service Administration Professional ExperienceProvider Data Service Analyst II,04 2010to09 2015National Vision Grand Rapids,MI,Duties include preparation and execution of provider contracts, loading contracts fee schedules and benchmarks, maintaining provider data such as demographic information.Problem solving to ensure contract arrangements enable the accurate adjudication of claims payments and assistance in contract administration.Identify trends and problems through an assessment of practices, and develop new processes and activities and build a business case for execution, incorporation or adaptation.Participation in the creation of, and compliance with, provider policies and procedures dealing directly with dedicated provider groups.Ensure appropriate investigation and issue resolution, loading and maintenance of contracting arrangements containing several lines of business for provider contracts and provider demographic data in multiple claims administration systems, including but not limited to PIP (Provider Information Platform) and Diamond DFS.Configures provider payment arrangements through integration of provider contractual arrangements, product benefit standards, in order to facilitate accurate claims payment.Coordinate with operational areas and other departments within the delivery system such as network management for due diligence.Resolves provider data and payment discrepancies by interpreting contract language and apply appropriate pricing methodologies and contractual arrangements to facilitate accurate and timely resolution of provider claims payment issues.Build and maintain strong relationship business relationship whether internal or external.Provide dedicated management of provider demographic data and contract arrangements for Minute Clinic, Take Care Health, and CareSpot.Ensure integration and coordination with all Florida Blue Operational areas.Consultant on development of business requirements for provider maintenance and contracting under new Provider Information Management System (PIMS).(Analyst II) Contractor,04 2010to01 2012Blue Cross Blue Shield Of Florida City,STATE,Duties include coordination of contract loads and maintenance of provider data files.Experience in collaborating and building strong relationships with internal and external business partners promoting positive results.Negotiating with external business partners to achieve and influence customer outcomes and meet the targeted set leadership goals.Coordinate activities for continuous improvement efforts.Perform special projects tied to managing territories targeted for Network expansion and associated priorities, action plans and tasks set to meeting targeted outcomes.Perform and lead special initiatives by identifying, developing, recommending, and implementing process, procedure and product.Proficiency in interpreting provider reimbursement methodologies.Coordination with business partners and network management on fee schedule builds that apply to contract reimbursement.In depth knowledge of provider payment programs and billing practices such as coding, subject matter, expert tools (PIP, Diamond, Siebel, DMT, Online Provider Directory and other delivery system tools) and processes to support temporary resource projects.Responsible for following all process and procedures for the four core PPDO business processes, of which include Contracting, Registration, Maintenance and Termination.Confirming that information loaded to provider s files interface to all systems and loading necessary fee schedule history of HMO, MM, NWB, NWMBA, PPC, PPS, MDS, MDB, BSC and PFS lines of business.Assistant Manager,11 2006to07 2009Seven-Eleven City,STATE,Prepared and presented training materials to new employees.Ensured that the store met CDC regulations by regularly performing inventory reports.Monitor, evaluate, and take action to improve individual and team target goals.Planned and established work schedules (e.g., vacations, work shift, coverage for absent team members.)Provided motivation, inspiration, and developmental support to staff through coaching, providing feedback, reward and recognition. Skillsbilling, BSC, business case, business processes, cashiering, coach, coaching, Consultant, continuous improvement, contract administration, contracts, Client, excellent customer service, delivery, due diligence, French, health care industry, IMS, inspiration, Internet Explorer, inventory management, inventory, team building, leadership, leadership skills, managing, Microsoft Access, Microsoft Excel, Microsoft Outlook, Microsoft PowerPoint, Microsoft Windows 7, Microsoft Word, Negotiating, network management, Network, organizational skills, performance appraisals, policies, presenting, pricing, Problem solving, processes, producing, coding, project management, shipping, Siebel, training materials, verbal communication skills, written  SEP  Provides analysis to different functions such as ManufacturingOperations, SIOP, Sales, Customer Service, Sourcing, Finance, Digital and management of the entire business in reviewing, analyzing, documenting and validating user requirements, applications and processes. Work with stakeholders throughout the organization to identify opportunities for leveraging company data to drive business growth in the current and new revenue streams. Key Responsibilities Gathers and evaluates data from multiple sources. Analyzes, reconciles and identifies measurable opportunities for improvement. Identifies and implements audit processes to ensure data issues are identified, tracked, reported and resolved in a timely manner. Develops and maintains processes to continuously monitor data quality and integrity across the business. Creates and maintains workflows and approval processes based on internal stakeholder requirementsActs as subject matter expert for new processes, KPIs, and data management. Collaborates with external and internal customers to analyze information needs and functional requirements. Partners with various leaders to design optimal solutions that meet the business needs of our internal and external customers. Coordinate with different functional teams to implement models and monitor outcomes. Develop processes and tools to monitor and analyze model performance and data accuracy. Develop custom data models and algorithms to apply to data sets. Mine and analyze data from company databases and web platforms to drive optimization and improvement of product development, marketing techniques and business strategies. Assess the effectiveness and accuracy of new data sources and data gathering techniques. Professional ExperienceQualifications Have at least 3-5 years of experience as Data Analyst or a related field. Candidate must possess at least a Bachelors Degree. Detail oriented and accurate. Proficient in MS Excel (including pivot tables). Strong analytic skills related to working with structured and unstructured datasets. Flexible, able to work on own initiative, deal with more than one project at a time, can work under pressure and tight deadlines, and prioritize tasks accordingly. Very good communication skills, verbal and written. Self-starter and a strong team player. Sophisticated problem-solverHigh knowledge of Power BI or similar analytics toolsStrong knowledge of Google Analytics, Adobe Analytics or other web analytics platforms. Python andor R language experienceSolid experience building Microsoft Power Apps and in Power AutomateExperience in visualizationStrong understanding of SQLOracle Knowledge Benefits Medical, Dental, Vision and Prescription Drug CoverageSpending accounts (HSA, Health Care FSA and Dependent Care FSA)Paid Time Off and Holidays401k Retirement Plan with Matching Employer ContributionsLife and Accidental Death Dismemberment (AD D) InsurancePaid LeavesTuition Assistance About Regal Rexnord Regal Rexnord Corporation (Regal Rexnord) is a leading manufacturer of electric motors, electrical motion controls, power generation and mechanical power transmission products and sub-systems, serving customers around the world in the general industrial, consumer, commercial construction, food beverage, and alternative energy end markets, among others. Regal Rexnord sells its products and solutions to OEMs, through distributors, and directly to end-users. Regal Rexnord is a 7.2B company with 36,000 associates globally. You may not know it, but Regal Rexnord impacts your life every day. The companys products enable the fans in HVAC systems that keep us comfortable the power source that keeps smart buildings running the agricultural and food service equipment that keeps us fed and the conveyer systems that keep e-commerce flowing, to name a few of the applications where our products are used. Regal Rexnords business purpose is to create a better tomorrow by energy-efficiently converting power into motion. This means creating innovative solutions while focusing on both customer needs and the companys commitment to sustainability. The companys industrial powertrain and automation solutions offerings are an important part of the company s growth strategy. The companys strategy includes leveraging 8020 to prioritize all activities, including product excellence, operational excellence and commercial excellence (i) driving organic sales growth through the introduction of innovative new products, with a particular focus on improving energy efficiency, (ii) establishing and maintaining new customers, as well as developing new opportunities with existing customers, (iii) participating in higher growth end markets and geographies, and (iv) identifying and consummating strategic, value creating acquisitions. Equal Employment Opportunity Statement Regal Rexnord is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sexgender, sexual orientation, gender identity, age, ancestry, national origin, marital status, citizenship status (unless required by the applicable law or government contract), disability or protected veteran status or any other status or characteristic protected by law. Regal Rexnord is committed to a diverse and inclusive workforce. We are committed to building a team that represents diverse and inclusive backgrounds, perspectives, and skills. Notification to Agencies Please note that Regal Rexnord Corporation and its affiliates and subsidiaries ( Regal Rexnord ) do not accept unsolicited resumes or calls from third-party recruiters or employment agencies. In the absence of a signed Master Service Agreement or similar contract and approval from HR to submit resumes for a specific requisition, Regal Rexnord will not consider or approve payment to any third-parties for hires made.

ATS compatibility score: 21.7 (No Fit)