1. Michael J. Kerwin
13 Elmhurst Ave. Albany, NY 12203
(518) 542-3348
michaelkerwin@earthlink.net
Objective
To obtain a position that will utilize my analytical and interpersonal skills as well as my
extensive knowledge of Trizetto Facets and NetworX configuration.
Work History
2012-Present NetworX Configuration Analyst
Blue Shield of Northeastern New York, Albany, New York
• Divisional lead configuration analyst for corporate project to convert pricing from core
Facets to NetworX Integrated Pricer.
• Work closely with Network Contracting and external consultants to ensure accurate
pricing configuration based on the provider’s contracts.
• Update existing NetworX agreements as well as agreements remaining in Facets as
provider’s contracts were renegotiated.
• Perform extensive unit testing on new agreements.
• Provide on the job NetworX configuration training for new employees.
1998-2012 Systems Configuration Analyst
Blue Shield of Northeastern New York, Albany, New York
• Responsible for the timely configuration of products and provider agreements in Facets to
ensure accurate claim payment.
• Analyzed and assisted in problem resolution through trouble ticket and change request
process to ensure compliance with corporate standards.
• Worked as configuration lead with the Marketing and Product Development Teams to
implement several new product lines including a new HMO plan, Medicare Advantage
plan and the first ASO product implementation for my division.
• Resolved complicated claims errors and made necessary configuration changes to prevent
recurrence.
• Provided on the job configuration training for new employees.
1993-1998 Senior Claims Examiner/Adjuster
Empire Blue Cross, Albany, New York
• Reviewed and investigated medical claims to determine eligibility for benefits according
to specific contractual provisions.
• Worked closely with Customer Service Unit to review and adjust, if necessary,
previously processed claims being disputed by members or providers.
• Provided quality control, technical support and on the job training for Jr. Claims
Examiners and Adjusters.

2. Education
Hudson Valley Community College: Troy, New York.
Awarded Associate of Applied Science Degree in Business Administration - May 1990.
Skills
• Comprehensive knowledge of Facets Applications including Application Support, Claims
Processing, Criteria Maintenance, Customer Service, Dental Plan, Dental Provider
Agreement, Medical Plan and Medical Provider Agreement.
• Certified in NetworX Integrated Pricer.
• Proficient in Microsoft Word, Excel and Access.
References available upon request.