Sara Hayes
Sr. Technical Product Manager at Cody Consulting Group- Claim this Profile
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Bio
Credentials
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Dashboard in a Day - Power BI
Pragmatic WorksMar, 2023- Nov, 2024 -
Data Storytelling with Power BI Workshop
Pragmatic WorksMar, 2023- Nov, 2024
Experience
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Cody Consulting Group
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United States
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IT Services and IT Consulting
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1 - 100 Employee
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Sr. Technical Product Manager
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Aug 2021 - Present
Provides guidance and leadership on the more technical aspects, features, and functionality of our Medicare Reconciliation system. Works closely with the development & engineering teams as a key liaison between the business and IT. Consults with sales, marketing, and the business on the more technicalaspects of each client and/or go-to-market initiative.Assess technical client specifications, requirements, prioritization, business architecture, and scheduling plans based on development’s estimate. Participates in testing, security, scalability, and infrastructure activities. Works with outside third parties for integration, API, and/or technology partnershipopportunities. Show less
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Senior QA Analyst
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Jan 2021 - Aug 2021
Worked independently or as part of a Test Team to perform manual testing. Coordinated production job schedules and where appropriate, gathered input data files, and ran jobs timely using the API console. Identify issues with data feeds and notify Corporate Management and the Account Managers of blockers. Acted as the primary backup to the Technical Program Manager as needed to coordinate test cycles.
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Sr QA Tester
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Jan 2020 - Dec 2020
Developed and documented test scripts to cover functionality developed within the Sprint/release. Coordinated and/or created appropriate Test data. Determined the type and volume of test data needed to provide adequate test case coverage. Maintained an inventory of Automated Test Scripts for regression testing. Coordinated with the designated test team to identify appropriate test coverage. Worked with Business Units to define Business Requirements that effectively identify “testable” functionality. Documented and track requirements to Test Scenarios and Test Scripts. Created and submitted to Business and Corporate Management Acceptance Criteria for functionality incorporated in a release. Show less
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Senior Operations Expert
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Feb 2018 - Dec 2019
Served as a liaison between Operations and IT to assist or gather business requirements needed for system modifications, enhancement, and implementations. Collaborated closely with developers to implement business requirements and provide guidance. Analyzes and synthesizes business requirements, including recognizing patterns and conceptualizing processes. Identified improvement opportunities (proactive and reactive) and assessed business processes and system inefficiencies. Supported system implementations, conversions, upgrades, enhancements. Show less
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Senior Reconciliation Analyst
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Jul 2017 - Feb 2018
Processed monthly reports. Responsible for auditing and reconciling all membership and billing discrepancies. Performed quality audits. Subject Matter Expert (SME) to project involving enrollment, reconciliation and billing.
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Colorado Access
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United States
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Hospitals and Health Care
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400 - 500 Employee
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Systems Operations and Compliance Specialist
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Jan 2016 - Jun 2017
Created workflow design, documentation, and data analysis for Provider Credentialing, Provider Network Services, Provider Contracting, Provider Configuration, and Claim Appeals. Monitored and provided claims oversight of the activities outsourced to the TriZetto Claims Department. Coordinated research efforts for inquiries and special projects involving claims payment and integrity. Represented claims and served as claims SME in external audits.Project Manager for the close-out of Medicare contracts with CMS. Show less
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Medicare Compliance Specialist
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Jul 2014 - Dec 2015
Submitted and tracked Medicare sales events and marketing materials to CMS via HPMS. Was responsible for monitoring and reporting on timeliness and quality of resolution of issues entered through the CMS Complaint Tracking Module. Developed and conducted training sessions on Medicare compliance-related topics and requirements for internal and external parties. Maintained the Compliance 360 system for Access Advantage. Assisted with internal audits and compliance reviews. Assisted with the dissemination of new and revised CMS guidance to appropriate individuals. Coordinated the administrative details for the Medicare Compliance Officer, including preparing complex and confidential documents and reports and composing and handling complex correspondence. Communicated with operational staff and management regarding Medicare program obligations. Show less
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Anthem, Inc.
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United States
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Hospitals and Health Care
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700 & Above Employee
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Reconciliation Auditor
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Apr 2014 - Jul 2014
Key resource for team on projects. Ensured that membership information provided to the government was accurate and reconciled money received with account information. Performed quality audits to ensure financial compliance. Processed monthly reports.
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Membership Representative III
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May 2011 - Apr 2014
Resource during ESI migration, trained other team members on ESI, great point person on calls. Established as a go to person for projects and rush situations. Worked on projects writing business requirements for small system change requests (SSCRs). Answered questions about processes and assists in the writing of desk level procedures (DLPs). Great attention to detail. Maintained high quality and member timeliness.
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Membership Representative II
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Sep 2010 - May 2011
Resource for operation associates for workflow and technical related processes. Handled complex case research and resolution. Responsible for auditing and reconciling CMS rejected membership information and state pharmaceutical assistance programs (SPAP) membership nationwide. Provided assistance in training on current and new materials.
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Membership Representative I
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Aug 2009 - Sep 2010
Processed enrollments, disenrollment’s and plan changes in accordance with policy and procedures. Responded to inquiries concerning enrollment processes and maintained assigned accounts. Determined eligibility and verified enrollment statuses. Made changes to records and ensured accuracy and timeliness.
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Education
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Keller Graduate School of Management of DeVry University
Master of Business Administration - MBA, Business Intelligence and Analytical Management -
DeVry University
Bachelor of Science - BS, Technology Management -
Coastline College
Associate of Arts - AA, Criminal Justice -
Lincoln Tech
Diploma, Medical Billing and Coding
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