Experience

State Compensation Insurance Fund

• United States
• Insurance
• 700 & Above Employee

• Business Analyst

  • Jan 2013 - Present

  Responsible for eliciting, analyzing, documenting business and solution requirements for claims project. Acted as a business agent to identify and articulate the need for change in claims system functionality, and to facilitate that change. As a business analyst in the Claims Optimization project, I partnered with Price Waterhouse Cooper to identify and defined the business solutions that will add value to claims department. Acted as a business process analyst by analyzing the… Show more Responsible for eliciting, analyzing, documenting business and solution requirements for claims project. Acted as a business agent to identify and articulate the need for change in claims system functionality, and to facilitate that change. As a business analyst in the Claims Optimization project, I partnered with Price Waterhouse Cooper to identify and defined the business solutions that will add value to claims department. Acted as a business process analyst by analyzing the current business processes, identifying areas for improvement, and creating requirement documents to design and implement system related changes that meet business needs and improve daily claims operations.

• Associate Information Systems Analyst

  • Jan 2007 - Jan 2013

  Responsible for develop and support of the claims application and liaison between claims department and IT department resolving hundreds of issues and changes per year for the largest workers’ compensation insurance company in California. I took an initiative to step in and take over the complex claims/subrogation legal project after becoming aware that the original project lead was assigned other responsibilities. I was thorough in my analysis of the requirements, testing, and… Show more Responsible for develop and support of the claims application and liaison between claims department and IT department resolving hundreds of issues and changes per year for the largest workers’ compensation insurance company in California. I took an initiative to step in and take over the complex claims/subrogation legal project after becoming aware that the original project lead was assigned other responsibilities. I was thorough in my analysis of the requirements, testing, and communication with the project team and end users. This contributed to a successful product by developing quality test cases and making sure the project met its goals as envisioned. I involved to compliance projects as a business resource, such as EAMS Jet Filing, Management Claims Review (MCR) and Franchise Tax Board Backup Withholding (FTB) projects. I was able to provide business requirements, develop testing scenarios for both negative and positive testing and complete User Acceptance Testing (UAT) in claims and/or payment applications. I am also acting as a liaison between Business departments and the Information Technology (IT) department for the identification and resolution of problems and enhancement opportunities in existing programs. When there was a time, Claims Operation received questions on capturing the accurate data in our system. I work closely with IT to investigate and identify the reported production issues. In the meantime, I communicate with Business department to verify the findings. In addition, I help the Business compose and submit a Change Request to start the process immediately. And I continued to work with IT and Business on establishing a new requirement and UAT for the Change request. I was able to resolve and close this production issue less than 20 days.



State Compensation Insurance Fund

• United States
• Insurance
• 700 & Above Employee

• Workers Compensation Claims Representative

  • Jan 2002 - Jan 2006

  Responsible for manage and achieve timely resolution of a claim by estimating adequate reserves, rating permanent disability, negotiating settlements with injured workers and applicant attorneys. I was one of the top finalizers and closers in San Francisco Claims Office. All my liability decisions were made timely and well supported by documents in claim files. And I was able to keep low profile in penalties. Although the Workers’ Compensation industry had been facing Workers… Show more Responsible for manage and achieve timely resolution of a claim by estimating adequate reserves, rating permanent disability, negotiating settlements with injured workers and applicant attorneys. I was one of the top finalizers and closers in San Francisco Claims Office. All my liability decisions were made timely and well supported by documents in claim files. And I was able to keep low profile in penalties. Although the Workers’ Compensation industry had been facing Workers Compensation reforms and changes, I continued with my ability to provide good services to policyholders, claimants, attorneys and medical providers. During my supervisor’s absence, I was acting as supervisor to assist my fellow adjusters and train the new adjusters. Show less Responsible for manage and achieve timely resolution of a claim by estimating adequate reserves, rating permanent disability, negotiating settlements with injured workers and applicant attorneys. I was one of the top finalizers and closers in San Francisco Claims Office. All my liability decisions were made timely and well supported by documents in claim files. And I was able to keep low profile in penalties. Although the Workers’ Compensation industry had been facing Workers… Show more Responsible for manage and achieve timely resolution of a claim by estimating adequate reserves, rating permanent disability, negotiating settlements with injured workers and applicant attorneys. I was one of the top finalizers and closers in San Francisco Claims Office. All my liability decisions were made timely and well supported by documents in claim files. And I was able to keep low profile in penalties. Although the Workers’ Compensation industry had been facing Workers Compensation reforms and changes, I continued with my ability to provide good services to policyholders, claimants, attorneys and medical providers. During my supervisor’s absence, I was acting as supervisor to assist my fellow adjusters and train the new adjusters. Show less