Keith Condon

About Keith Condon

I am a goal-driven healthcare services professional with over sixteen years experience in the Health Plan and Health Insurance Industry. I am seeking a position that offers opportunities to master new concepts, skills and practices while providing me the opportunity to utilize my extensive knowledge of Business Processes and Informatics.Proficient in Web-Based Applications. Excellent problem solving and analytical skills. Exceptional multi-tasking and team collaboration skills. Experienced in business process configuration, customizations, designing, building, testing products and new implementations as well as upgrades and system integration. Knowledgeable of the supporting data structures with the ability to query tables as part of the configuration validation and auditing process.Specialties: Auditing, Benefits Administration, Customer Service, CMS, Relational Database Design, System Configuration, System Integration, System Upgrades, Testing, Implementations,Group and Membership Enrollment, Utilization Management, Case Management,Claims Adjudication,Gap Analysis, Mapping, Functional and Design Specs

Experience

1. Lead Configuration Analyst

   Excellus BCBS

   Jun 2010 — Present

   Runs validation queries in Microsoft Access to analyze Standard and Cobra Medical, Incentive Rewards, Pharmacy, and Medical Management Plans and Products in order to cross reference/map/and configure into Siebel Customer Resource Management Client System• Receives, reviews, and resolves discrepancies in the Facets Membership Group, Subscriber, and/or Member records and enters system corrections to ensure accurate and timely updating to the files• Runs Queries in Intelligroup and then configures Pharmacy Plasm/Farkey values and Rate Quotes for Community and Experienced rated Groups in Sail to Mail and Siebel CRM systems• Configures the following in Facets 4.71 for all new and active groups(benefit changes): Class/Plan Definition, Premium Rate Table, Groups, Subgroups, Billing Entity and Subscriber Family applications• Handles specialized activity such as Marketing Priorities and Action Requests• Validates and configures enrollment codes for various PPO,Commercial and HDHP Health Plans such as High Deductibles, Copays, Copay/Deductible

Skills

• Program Management
• Regression Testing
• Agile Methodologies
• Access
• Management
• Quality Assurance
• Software Development
• Business Analysis
• Integration
• Employee Benefits
• Software Documentation
• Sdlc
• Project Management
• Cross-Functional Team Leadership
• User Acceptance Testing
• Relational Databases
• Utilization Management
• Testing
• Requirements Gathering
• Insurance
• Visio
• Hp Quality Center
• Quality Center
• Data Warehousing
• Business Requirements
• System Administration
• Healthcare Information Technology
• Health Insurance
• Managed Care
• Healthcare
• Business Process
• Databases
• Auditing
• Test Cases
• Analysis