Experienced business systems analyst with over 20 years of experience in customer service, quality control, systems testing, and project management. Provides advanced technical support and testing expertise for large health insurance company. Works collaboratively with business and IT to develop solutions, test systems, and ensure processes meet requirements.

1. KAREN LYNN HILE
4610 Cedar Cliff Road Home: (336) 376-9175
Graham, NC 27253 Office: (919) 765-3611
Ext. 53611
SUMMARY: Experienced professional with proven capabilities in customer service, quality control, and system testing.
Considered a strong team player with excellent leadership and training ability. Works well under pressure while
maintaining high planning and organization levels.
PROFESSIONAL EXPERIENCE
BLUE CROSS BLUE SHIELD OF NORTH CAROLINA, Durham, NC 1999 - Present
The largest Health Insurer in the state of North Carolina.
Sr. Business Systems Analyst (2014 – Present)
Act as a liaison representing our department and the processes and workings within it to develop effective technical
solutions and minimize operational and system/application impacts. Coordinates with IT to support problem resolution,
testing, software upgrades and related projects of a more complex nature..
 Provide advanced technical knowledge and support in operational system/application and procedural issues to
the business and IT.
 Possess detailed and in-depth knowledge of the Inter-Plan Program, its processes and procedures, and have
strong familiarity with related mandates provided by the Association.
 Use judgment and initiative to review, analyze and develop solutions for business systems while identifying and
quantifying the business impact of those solutions.
 Provide systems analysis expertise and regularly considers the business implications of the application of
technology to the current business environment
 Coordinate ongoing user support for ad hoc questions, inquiries, and service requests.
 Coordinating with IT, other teams and vendors as needed to devise, test and implement long term remedies.
 Work collaboratively on projects and initiatives with the business and IT by eliciting and documenting business
requirements and preparing appropriate functional specifications while considering technical capabilities of the
system/application and ensuring an integrated approach is used.
 Review and approve technical specifications.
 Coordinates with IT on implementation and post implementation support.
 Coordinate and develop testing plans with Business area and IT.
 Serve as point of contact for business testing activities and influence testing strategy to ensure teting will
appropriately meet business requirements.
 Develop, document and may, in some cases, execute test plans and scenarios.
 Assist IT to help identify business area impacts for hardware and software upgrades, security changes and
architectural enhancements as needed.
 Configure and maintain critical system tables and data elements across multiple system environments.
Sr. Testing Specialist (2004 – 2014)
Ensures that operations and care management systems function efficiently and accurately and contribute to the
achievement of BCBSNC’s business objectives.
 Perform statistical analysis of system requirements and create test strategies, test cases and perform execution of
the test cases based on the Functional and Technical Specification walkthroughs.
 Develop business relations and integrate activities with other departments to insure successful implementation of
projects.
 Assist management with employee development initiatives including mentoring and training.
 Manage test scripts and reporting by use of Quality Center.
 Lead large projects
 Test EDI Transactions to include HIPAA X12 standard transactions including 837I, 837P, 835 and 27X
 Tasked with an initiative to train four offshore contractors on IPP Host and Home so they would be able to perform
regression testing for the ITS Mandated Releases and the execution will include new functionality starting with
IPP Release 15.0.
Business Systems Analyst (1999 – 2004)

2. Ensures that operations and care management systems function efficiently and accurately and contribute to the
achievement of BCBSNC’s business objectives. Responsible for the coordination between customer service areas and
Information Systems.
 Develop functional specifications for systems enhancements and testing; assess system impact of proposed
changes to include mandatory ITS version modification as well as determining impact to local system coding.
 Develop test strategy, create test plans and execute test scripts.
 Coordinate projects between customer areas, Information Systems, and/or external vendors to meet
Plan/Departmental goals.
 Schedule and facilitate meetings with Operations to discuss open production issues.
INTEGON INSURANCE, Burlington, NC 1991 - 1999
One of the nation’s leading property and casualty insurance companies specializing in car, motorcycle and commercial
vehicle insurance. Member of GMAC insurance group with combined $1.3 billion in net written auto premiums annually.
Project Analyst (1998 – 1999)
Responsible for promoting coordination and communication within each unit of Testing Department for assigned projects.
Monitor progress of projects and report to upper management.
 Completed project involving all lines of business across several states that saved company approximately
$500,000 for one business line alone.
 Trained three new testers in four weeks.
 Tested ongoing projects during unanticipated absences of team members.
 Maintained production rate file and GTAM updates on a daily basis.
Acceptance Tester (1994 – 1998)
Responsible for recreating actual production examples in a testing environment for programming enhancements made to
system. This includes rate revisions, state-mandated changes and technical updates for various states and product lines.
Assist Customer Service Representatives in clearing up and understanding system errors in a timely manner to control
backlog.
 Successfully completed introduction of new state-mandated regulations within 15 working days for $2.8 million in
written premiums.
 Developed matrices and tested projects involving the conversion of two systems.
 Created and maintained Excel spreadsheets for calculating rating formulas for various states.
 Tested and added feedback to verify the system and output mailed to thousands of agents, insureds, DMV and
Loss Payees nationwide were all Y2K compliant.
Quality Control Auditor (1992 - 1994)
Responsible for random auditing of all areas in policy operations to help define errors to minimize phone calls and poor
quality of products.
 Reviewed over 10,000 policies annually to minimize errors and promote customer satisfaction.
 Successfully analyzed quality results and offered feedback to individuals to help them maintain high quality goals.
 Contacted customers directly to ensure customer satisfaction.
Customer Service Representative (1991 – 1992)
Responsible for determining eligibility of risk for new applications using state guidelines. Promptly answered calls from
agents and insureds concerning billing, guidelines and quotes on premiums.
 Maintained above-average to excellent quality on all processed work.
 Completed work in a timely, accurate manner to control backlog in various states.
 Successfully learned a variety of tasks and insurance regulations for additional states to be more flexible for areas
in need.
 Received 11 qualitative awards for maintaining excellent quality and service.
EDUCATION: Graduate, Youngsville High School, Youngsville, PA
TRAINING: Introduction to Insurance Putting the Customer First
Business Writing CSTE Overview Course
LEAN Training HIPAA Training/HIPAA Transactions

3. Leadership 100 Facets 10-Day Technical Training
Leadership Development
COMPUTER/SYSTEMS: Excel Word TSO PowerMHS
ITS  CMID Mobius ALIM
Quality Center Query AS400 Mainframe Query
Blue2