hope richardson_senior ba resume_final
TRANSCRIPT
Hope L. Richardsonhttps://www.linkedin.com/in/hope-richardson-76678818
Colorado Springs, CO 80923Cell: 719-510-4609 [email protected]
SENIOR BUSINESS ANALYST
SummaryHighly seasoned and self-directed Business Analyst well versed in healthcare EDI transactions and user acceptance testing. Enjoy solving complex problems; deep-dive thinker. Excels at cultivating, managing and leveraging business relationships at all levels; respected by colleagues, business leaders and external stakeholders. Adept at interdepartmental coordination to maximize business functionality and efficiency. Eager to provide comprehensive healthcare and IT knowledge that extends over fifteen years and encompasses both the private and public sectors. Self-driven telecommute experience for over 5 years.
Highlights Highly proficient in; MS Office, MS Visio, MS
Access, MS Windows, SharePoint, Mercury 9.2, SDLC, Rally, XML, HTML, SOAP, Web Services, SQLNavigator/Toad
Extensive knowledge in Healthcare Claims and Claims Process
Strong problem-solving and analytical abilities
Project management and leadership Superb communication skills Requirements gathering and documentation User acceptance testing Scrum/Agile/ScrumMaster Critical thinking
Accomplishments Maintained Service Level Agreement maintenance requirements for all legacy system needs; providing
100% issue resolution. Responsible for the implementation of 48 Real-Time (270/271 and 276/277) connections from 2011-2012;
increasing Real time transaction volume by over 10 times. Established and maintained the Beta Testing Process to assist Healthcare payers and providers' offices;
providing Subject Matter Expertise to increase their overall claim payments and revenue. Managed project coordination for a new external Medicare Supplemental Payer; built internal engineering
and functional requirements, system integration details and taught the payers’ development and business teams about HIPAA X12 requirements for their 5010 Transactions.
Insured that all Print Image clients were remapped and trained for the required 5010 ICD-10 Government Mandate on October 1, 2015.
Professional ExperienceOptumInsight, UnitedHealth Group 2011 – March 2016Senior Business AnalystColorado Springs, CO
Worked closely with Management and multi-level teams to meet Government Healthcare mandates and maintain industry standards.
Training all call-center Service and Support Technicians and external clients on system enhancements or required changes to the 5010 HIPAA Transactions and ICD-10 Codes.
Instrumental in building test cases for engineering and quality assurance teams. Documented process flows and developed requirements for functional improvements and overall system
enhancements. Lead Senior Business Analyst over the Advanced Claims Editing (ACE) and Claims Manager validation
platforms.
HOPE RICHARDSON 719-510-4609 Page Two
Electronic Network Systems (ENS) - acquired by UnitedHealth Group 9/2006 2005 – 2011Quality Assurance Engineer LeadColorado Springs, CO
Oversaw the job performance of the three Quality Assurance Engineers; discussing ways to assist them in building new test cases, supplied new knowledge and created training documentation for all new Quality Assurance Engineers.
Built MQC Test Scripts, using Mercury 9.2, for both regression and smoke testing; providing QA with a "virtual" fifth QA resource, allowing for over 40% more of the system to be regression and smoke tested.
Worked side by side with multi-functional onshore and offshore development and business teams on large enhancement projects.
Was often called-in to provide backup for other Quality Assurance Engineer departments when needed or requested; saved the company over $150,000 per/day in legal fines within the Workman's Comp System.
Electronic Network Systems (ENS) 2004 – 2005Production Control Validation Department LeadColorado Springs, CO
Built the Production Control validations team, from one individual to six team members; supplying all training for new Production Control validation resources.
Created the method and log system used for tracking all Inbound and Outbound EDI healthcare files to various medical payers throughout the US.
Established the Production Control performance requirement standards; increasing the Clearinghouse's number of positive outbound claim files and claims reporting to the clients, improving upon the overall claim submission process.
Electronic Network Systems (ENS) 2001 – 2004Reports AnalystColorado Springs, CO
Created and maintained the overall EDI Transaction Reports process for all Inbound and Outbound EDI Healthcare Transactions, used by the Finance Department; providing them with totals used to verify payments to outside entities and to our clients.
Developed detailed tracking tools and reports for the Executive staff; providing them with solid insight as to how the company was growing on a monthly and quarterly basis.
Electronic Network Systems (ENS) 2000 – 2001Production Control AuditorColorado Springs, CO
Developed and maintained the Production EDI File Auditing Process for all inbound and outbound EDI healthcare files to various medical payers throughout the United States; to insure that the payer received our clients' claims and that the payer responded with accurate reporting.
Education & Professional DevelopmentPPI Health Careers School - Colorado Springs, CO 1995-1996Certificate in Health Unit CoordinationCompleted Courses in Human Anatomy & Physiology, Sociology, Grammar & English, Medical Terminology, and Dictation & Writing.
University of Colorado at Colorado Springs - Colorado Springs, CO 1991-1992Completed Courses in Human Sexuality, Sociology, Voice and Diction, Theatre & Dramatic Studies, Sculpting & Art Design.
UnitedHealth Group Training Program - Salt Lake City, UT 2011CSM Agile/ScrumMaster Certification