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JOSHUA D LEVI
14605 SW 94th Lane, Miami, FL, 33186
786-459-3234 Email: Jdlevi88@yahoo.com
Accuracy, Insights, Results
PROFESSIONAL HIGHLIGHTS
 Processed,reconciledandreportedon EDItransaction files(834BenefitEnrollment/837Claims)
 Developed,implemented,andmonitored call trafficmanagementcompliance andauditing reportsfor
75 agentcall center
 Preformed workforce analysis,reportingandauditingfor anAvayaphone system
 Developedreports andperformedscheduledanalysisrelatedtoQNXT(TriezettoSystem)for:
o Membership
o Enrollment
o Error Log Processing
 Developedqueries andreportsandpresentedanalytical findingsusingSQLManagementStudio
 CreatedBusinessRequirementsDocuments workingwithclient,internal staff andprogrammers
 IT HelpdeskTechnicianlevel 1experience
INFORMATION TECHNOLOGY & MANAGEMENT EXPERIENCE
IndependentLivingSystems,Miami Florida33301
Business&MemberAnalyst November2012 – July2015
 Trizetto’sQNXTClaimsPaymentSystem - Configurationof the membershipformanagedlongtermcare
programswithinQNXTformultiple states thatincludedconfiguringsponsors,org policies, policyplans,and
rate tables
 Sponsors – configured ahealthplanprogramwithinQNXT
 OrgPolicies –responsibleforconfiguringOrgPolicyinformation,COB(coordinationof
benefits),Premiums, andPremiumRatesunderthe OrgPolicy
 PolicyPlan – configured the policyinformationwhichincludespolicyname,policyprogram,
dependentterms,policyrules,andattachingabenefitplantothe policy
 PremiumRate Tables – configured the rate codesandpremiumamountsfora program
 Business/MembershipAnalysis
 Testedmembershiprequirementsbeingtransferredfromthe ProprietaryCare Management
SystemtoQNXT before the startof managedlongtermcare programs
 Createdreportsuponrequestformembership,provider,authorization,andclaimsdata by
creatingSQL queries
 ImplementationTeamRole
 Responsible forassuringnew regionsof businesswithin the managedlongtermprogramsare
configuredproperly
 Responsible formanagingandanalyzing834 EDI filesbeingsentfromthe ProprietaryCare Management
SystemtoQNXT
 Identified andreported on834 EDI file issues beingsentfromthe ProprietaryCare ManagementSystem to
QNXTthat were affectingmembershipandenrollment
 Responsible forfixingandimportingany834 change filesthatfail toloadto QNXT
 Responsible forcommunicatingwithdevelopmentteambywriting BusinessRequirementsDocuments and
change requestformsinreference to834 change filesandupdatinglogiconthe manage longtermcare
system
 Accountable fortestingandapprovingall newlydevelopedandexisting834 change filesforproduction
JOSHUA D LEVI
14605 SW 94th Lane, Miami, FL, 33186
786-459-3234 Email: Jdlevi88@yahoo.com
Accuracy, Insights, Results
 Analyzedandassuredmembershipandenrollmentdata matchedacrosssystems bycreatingSQLqueries
 Assuredall AssistedLivingFacilityproviders were assignedcorrectlyacrosssystemsinQNXTinordertopay
claim, bycreatingSQL queries
 Responsible forreportingandfixingmembershipandenrollmentissuesmanuallythroughdataentry within
QNXT
 BuiltdesktopproceduresformembershipandenrollmenttasksforQNXT
IndependentLivingSystems,Miami Florida33301
Workforce Analyst August2010 – October2012
 Responsible formanaginghunt groupsandqueueswithinacall centerof 75 people
 Createdcall reportsthat auditedandanalyzeddepartmentswithinthe company
 Setuproot cause analysisandtrafficmanagementreports todetermine the numberof agentsneededto
handle variousworkloads
 Responsible forbuildingandmanagingreportsthatwere necessary tostayincompliance withfederal,state,
healthplan,andinternal compliancestandards
 Responsible forassuringphone statisticswere atleast10% above compliance
 Improved the call centeranswerrate from 70% to a 90% answerrate
 Assuredhuntgroupstransferredandqueuedtothe correctagents
4IT-Inc., Miami Florida33186
HelpdeskTechnician,Level 1 November2007 – August2010
 Handledlevel 1helpdesktaskswhichincludedassisting userswith MicrosoftOutlookissues,cleaningviruses
and malware, assistingwith Shoretel phonesystemissues,andmanaginguseraccountsthroughActive
Directory
 Responsible forassuringthatall contractedcompanieshadworkingdailybackupsthrough SymantecBackup
Exec2010 and 2012
 Createdandclosed ticketswithinConnectwise foranyITservicesneeded
 Workedon projectshandlingcabling andrack work
 Benchwork includinginstallationof harddrives,memory,operatingsystems,anddrivers.
 Ordered andtackedequipmentordered forclientsthrough DellandTech Data online systems.
SOFTWARE KNOWLEDGE
MS Word MS Excel MS Outlook Active Directory Backup Exec______
QNXT(Trizetto) Connectwise SQL QueryLanguage Quickbooks_____ Shoretel_________
EDUCATION
Miami-Dade College
Associates of Arts 2014
BusinessAdministration 2016 (expected)
REFERENCES – Available Upon Request

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Joshua Levi Resume

  • 1. JOSHUA D LEVI 14605 SW 94th Lane, Miami, FL, 33186 786-459-3234 Email: Jdlevi88@yahoo.com Accuracy, Insights, Results PROFESSIONAL HIGHLIGHTS  Processed,reconciledandreportedon EDItransaction files(834BenefitEnrollment/837Claims)  Developed,implemented,andmonitored call trafficmanagementcompliance andauditing reportsfor 75 agentcall center  Preformed workforce analysis,reportingandauditingfor anAvayaphone system  Developedreports andperformedscheduledanalysisrelatedtoQNXT(TriezettoSystem)for: o Membership o Enrollment o Error Log Processing  Developedqueries andreportsandpresentedanalytical findingsusingSQLManagementStudio  CreatedBusinessRequirementsDocuments workingwithclient,internal staff andprogrammers  IT HelpdeskTechnicianlevel 1experience INFORMATION TECHNOLOGY & MANAGEMENT EXPERIENCE IndependentLivingSystems,Miami Florida33301 Business&MemberAnalyst November2012 – July2015  Trizetto’sQNXTClaimsPaymentSystem - Configurationof the membershipformanagedlongtermcare programswithinQNXTformultiple states thatincludedconfiguringsponsors,org policies, policyplans,and rate tables  Sponsors – configured ahealthplanprogramwithinQNXT  OrgPolicies –responsibleforconfiguringOrgPolicyinformation,COB(coordinationof benefits),Premiums, andPremiumRatesunderthe OrgPolicy  PolicyPlan – configured the policyinformationwhichincludespolicyname,policyprogram, dependentterms,policyrules,andattachingabenefitplantothe policy  PremiumRate Tables – configured the rate codesandpremiumamountsfora program  Business/MembershipAnalysis  Testedmembershiprequirementsbeingtransferredfromthe ProprietaryCare Management SystemtoQNXT before the startof managedlongtermcare programs  Createdreportsuponrequestformembership,provider,authorization,andclaimsdata by creatingSQL queries  ImplementationTeamRole  Responsible forassuringnew regionsof businesswithin the managedlongtermprogramsare configuredproperly  Responsible formanagingandanalyzing834 EDI filesbeingsentfromthe ProprietaryCare Management SystemtoQNXT  Identified andreported on834 EDI file issues beingsentfromthe ProprietaryCare ManagementSystem to QNXTthat were affectingmembershipandenrollment  Responsible forfixingandimportingany834 change filesthatfail toloadto QNXT  Responsible forcommunicatingwithdevelopmentteambywriting BusinessRequirementsDocuments and change requestformsinreference to834 change filesandupdatinglogiconthe manage longtermcare system  Accountable fortestingandapprovingall newlydevelopedandexisting834 change filesforproduction
  • 2. JOSHUA D LEVI 14605 SW 94th Lane, Miami, FL, 33186 786-459-3234 Email: Jdlevi88@yahoo.com Accuracy, Insights, Results  Analyzedandassuredmembershipandenrollmentdata matchedacrosssystems bycreatingSQLqueries  Assuredall AssistedLivingFacilityproviders were assignedcorrectlyacrosssystemsinQNXTinordertopay claim, bycreatingSQL queries  Responsible forreportingandfixingmembershipandenrollmentissuesmanuallythroughdataentry within QNXT  BuiltdesktopproceduresformembershipandenrollmenttasksforQNXT IndependentLivingSystems,Miami Florida33301 Workforce Analyst August2010 – October2012  Responsible formanaginghunt groupsandqueueswithinacall centerof 75 people  Createdcall reportsthat auditedandanalyzeddepartmentswithinthe company  Setuproot cause analysisandtrafficmanagementreports todetermine the numberof agentsneededto handle variousworkloads  Responsible forbuildingandmanagingreportsthatwere necessary tostayincompliance withfederal,state, healthplan,andinternal compliancestandards  Responsible forassuringphone statisticswere atleast10% above compliance  Improved the call centeranswerrate from 70% to a 90% answerrate  Assuredhuntgroupstransferredandqueuedtothe correctagents 4IT-Inc., Miami Florida33186 HelpdeskTechnician,Level 1 November2007 – August2010  Handledlevel 1helpdesktaskswhichincludedassisting userswith MicrosoftOutlookissues,cleaningviruses and malware, assistingwith Shoretel phonesystemissues,andmanaginguseraccountsthroughActive Directory  Responsible forassuringthatall contractedcompanieshadworkingdailybackupsthrough SymantecBackup Exec2010 and 2012  Createdandclosed ticketswithinConnectwise foranyITservicesneeded  Workedon projectshandlingcabling andrack work  Benchwork includinginstallationof harddrives,memory,operatingsystems,anddrivers.  Ordered andtackedequipmentordered forclientsthrough DellandTech Data online systems. SOFTWARE KNOWLEDGE MS Word MS Excel MS Outlook Active Directory Backup Exec______ QNXT(Trizetto) Connectwise SQL QueryLanguage Quickbooks_____ Shoretel_________ EDUCATION Miami-Dade College Associates of Arts 2014 BusinessAdministration 2016 (expected) REFERENCES – Available Upon Request