I am a customer focused technical resource who is seeking full time employment in the greater Atlanta area. I am a problem solver with a proven record for success.

1. Laurie D. Maxwell
Email: LaurieMaxwell@yahoo.com 404-285-6586 (cell)
Skills
 Experienced in SQL Oracle and T-SQL SQL queries and table driven databases. (SQL Developer and SQL
Server Management Studio programs)
 Maintained and monitored daily data receipt tracking and processing for timeliness and Service Level Agreements
 Numerous Data Investigations regarding clinical suites and measures and placement for HEDIS scoring
 Experienced in Electronic Data Warehousing (EDW) and Cognos Impromptu software for EDW (SQL) Inquiry.
 Extensive experience with CPT, ICD9, HCPCS and facility revenue medical coding terminology.
 Expert in HL7 formats and data transmissions.
 Current and informed regarding Blue Cross Association’s Attribution reporting due mid 2015.
 Expert in Business Objects for data analysis, reports and mapping of universes
 Experienced in FoxPro and Crystal Reports report writing applications.
 Expert in all Microsoft Windows programs including Access, Excel, Word and Word Perfect, Power Point, Outlook,
MS Project, Publisher, Visio, Adobe Acrobat and Web applications
 Experience with regulatory compliance for HIPAA, SOX, HEDIS and ISO17799
 Extensive experience in Geo Access programs including Geo Referral and Geo Directory
 Skilled in ASA Caps, Erisco, NASCO and Amisys claims systems and HBOC Credentialing system.
 Experience with McKesson Claim Check software including “Clear Claim Connection”
Strengths
Excellent PC knowledge and customer service skills with extensive experience in written and verbal communications.
Excellent analytical and organizational skills. Creative approaches to teaching technical processing techniques and
analytical logic. Creative problem solving skills. Highly motivated and goal oriented, accurate, thorough and precise in
attention to details. Excellent communication skills to and from programmers to end-users. Completed Project
Management Methodology training and AMA Time Management Training. Extensive experience in technical support
and statistical reporting. Extensive knowledge of Medical Terminology and Procedures including coding and billing
processes.
Professional Experience
SENIOR DATA ANALYST / QA ENGINEER III 04/14 to 06/16
Symphony Performance Health Analytics Alpharetta, Georgia
MDdatacor was purchased by SPH Analytics. Researched structured clinical data files and created queries for data
validation for statistical reporting. Reviewed medical traits for data integrity and clinical accuracy. Extensive use of
SQL Developer in an Oracle based database. Reviewed query outputs for data integrity and quality assurance.
Created monthly management dashboards that showed membership trends and clinical suite trends for each of our
sponsor clients. When moved into the I.T. department, I began Wiki documentation for T-SQL Stored procedures and
functions. Performed User Acceptance Testing (UAT) on newly coded functions for accuracy. Verified conversion of
tables from Oracle to SQL Database functionality.
DATA ANALYST TEAM LEAD 09/04 to 04/14
MDdatacor Alpharetta, Georgia
Reviewed large amounts of unstructured data to determine best processing practices on the proprietary MDdatacor
“Splitting and Parsing” software. Reviewed thousands of text files while maintaining accuracy and efficiency under the
HIPAA guidelines concerning personal medical information and the parsing of this information. Trained new Data
Analysts in use of the MDdatacor proprietary software and analytical principles. Created training documentation for
statistical sampling and analyzing clinical data. Researched clinical unstructured text and created rules for data
validation to create scenarios for statistical reporting. Reviewed medical traits for data integrity and clinical accuracy.
Extensive use of Access and Business Objects for customer reports and clinical trial rosters. Reviewed report output
for data integrity and quality assurance. Assisted with development of the “MDdatacor Data Care Center” for the
Health Insurance Industry payer community.
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2. SR. USER APPLICATIONS ANALYST II 02/01 to 06/04
Blue Cross Blue Shield of Georgia Atlanta, Georgia
Ran extensive Cognos reports for claims data from the Electronic Data Warehouse (EDW) systems. Developed
functional business requirements and translated them into system requirement specifications. Analyzed claims data
for patterns and trends to formulate recommendations for process improvement and automation. Created user
acceptance testing (UAT) scenarios for logic and benefit changes. Served as Project Lead and successfully
implemented over 80 accounts onto the main frame system. Maintained all project documentation including project
plans, issue logs and test scenario scripts. Developed financial processes documentation in accordance with the
Sarbanes-Oxley federal mandate. Integral part of raising the Claims First Pass Rate from 63.41% to 71.94%. Assisted
auditing department with mapping and identification of critical fields within EDW historical claims data. Automated a
full benefit library for all accounts within the NASCO system. Administered security and maintenance of the online
benefit inquiry and online help applications for the entire NASCO division of BCBSGA.
PROJECT COORDINATOR 03/99 to 01/01
National Account Service Company (NASCO) Atlanta, Georgia
Served as Implementation Project Lead for over 90 new accounts for the BC/BS Plans. Coordinated with Blue Cross
and Blue Shield Plans across the nation on negotiating and implementing system changes. Created user acceptance
testing (UAT) scenarios for all implementations. Completed user acceptance testing and maintained project issue logs
and test scenario scripts. Worked extensively with Project Management Methodology (PMM) phases and
documentation including problem analysis, business need, and cost and feasibility studies to determine the most
effective solutions. Calculated Return on Investment (ROI) and documented full life cycle of small to medium projects.
Served as liaison between the technical vendors (EDS and IBM) and the customer.
NETWORK SERVICES REPRESENTATIVE 11/97 to 03/99
Medicare Secure Choice Atlanta, Georgia
Managed a FoxPro database for over 2500 providers. Also, managed a Microsoft Access database for over 1000 out
of area providers for possible expansion. Coordinated provider information for credentialing, marketing, enrollment,
member services and administration. Administered all reports and tables for HCFA, HEDIS and NCQA guidelines and
audits. Produced all reports for all business needs in the company. Reviewed report output for integrity of data.
Developed, maintained and published the network provider directory.
CUSTOMER SERVICE REPRESENTATIVE 03/94 to 11/97
Connecticut General Life Insurance Co. Atlanta, Georgia
Handled in excess of 70 calls per day regarding the processing of HMO health claims. Educated members on all
guidelines and protocols of managed care programs including Medicare and coordination of benefits. Extensive
communications with members and providers. Creative problem solving regarding provider contract issues and
electronic claims submission issues. Handled all appeals and grievances for the Florida healthplans.
Training & Education
Regulatory Compliance Security Training MDdatacor March 2006 to June 2016
Business Objects 6.5 “Intermediate Reporting” Business Objects SA July 2005
Diversity in Business WellPoint August 2003
HIPAA Policies & Security WellPoint June 2003
MS Project 98 ExecuTrain April 2000
Total Time Management Padgett Thompson AMA January 2000
Project Management Methodology NASCO November 1999
Dekalb Community College/Dekalb Technical School
Certificate in Accounting
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