George Crowley

Experience

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  Empire Blue Cross Blue Shield

  Jan 1993 - Jan 1997

  Supervisor - Institutional Client Services

  Empire Blue Cross Blue Shield - Syracuse, NYSupervisor – Institutional Client Services 1993-1997  Managed Institutional Client Services customer service help desk. Responsible for providing excellent customer service support, training helpdesk analysts, developing and implementing workflow procedures to improve service.  Administered annual employee performance reviews.

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  Empire Blue Cross Blue Shield

  Jan 1998 - Jan 2002

  Senior Systems Analyst

  Empire BlueCross/BlueShield – Syracuse, NYSenior Systems Analyst 1998 – 2002  Resolved telecommunication application problems for EDI transmissions. Analyzed and resolved problems escalated from help desk. Coordinated vendor, provider, and submitter enrollment and qualification. Maintained MS Access vendor database. Provided testing analysis and support to electronic providers and vendors. Performed acceptance testing and regression testing for front-end application. Developed GUI design and business process requirements for HIPAA EDI implementation. Show less

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  IBM Global Business Services Talent & Engagement

  Jul 2001 - Feb 2005

  Senior Systems Analyst

  IBM GLOBAL SERVICES, AMS Empire BlueCross/BlueShield Account – Syracuse, NYSenior Systems Analyst July 2001 – February 2005 Responsible for resolving 2nd level tickets escalated from the IBM Help Desk. Primary liaison and designated point for Empire EDI trading partners. Maintained and revises specifications according to business requirements.  Provided analysis, requirements, and testing support to IT department. Tracked statistics and provided monthly reports to senior management. Performed acceptance and regression testing support for legacy systems and new development. Show less

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  AXA US

  Apr 2005 - Sept 2005

  Senior Business Analyst

  AXA Equitable Insurance Company (Retirement Annuity ContractsSenior Business Analyst Consultant April 2005 – September 2005 Primary Analyst, providing new business production support for an annuities contract administration system. Developed and input regression test cases, and analyzed results. Reviewed annuity prospectus policy statements and reports for content. Maintained Lotus Notes data mapping database.

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  SCHC Companies – Total Care, Inc. (New York State Medicaid Contract Payer)

  Jan 2006 - Nov 2013

  Business Analyst

  SCHC Companies – Total Care, Inc. Syracuse, NYBusiness Analyst January 2006 – November 2013  Analyze and support AMISYS Health Insurance Application Payer System. Configure AMISYS Modules with expertise in Pricing, Benefits, and Authorization. Create test plans and user cases to validate configuration changes. Perform review of new business requirements for Medicaid, Child Health Plus (CHP), Family Health Plus, (FHP) government programs. Analyze and recommend workflow, procedure, or systematic changes to ensure the efficient processing of claims and membership transactions. Coordinate with AMISYS vendor, DST Health Care Solutions, IT consultants and Total Care staff on projects and production support issues. Perform queries to produce trend analysis reports for other departments. Subject matter expert for system interfacing with AMISYS application with OPTUM for APG and DRG Easy Group Server Processing.  Load Medicare and Medicaid and Custom Fee Schedules used for pricing. Provide testing support for system patches and system release upgrades. Worked closely with QA staff to ensure system changes implemented had no negative impact on system. Show less

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  CareConnect Insurance Company, Inc.

  Dec 2013 - May 2018

  Senior Analyst Configuration Application Support

  Northwell Health CareConnect Insurance Company, Inc. East Hills, NY Senior Analyst, Configuration Application Support December 2013 – Present In 2013 I joined a team of seasoned Healthcare professionals at CareConnect Insurance Company, Inc. a start-up company of Northwell Health for my expertise and experience configuring and supporting health insurance payer applications. My primary role is implementing and testing system configurations along with providing application support.  Configure and Test AMISYS Advance Pricing and Benefit Contracts.  Coordinate with vendors and internal departments which include Provider Relations and Contacting, Claims, Utilization Medical Review, Finance, Underwriting, Quality Assurance.  Configure and support Application System Security Access.  Provide testing support for system patches and system release upgrades Identify issues through root cause analysis to the completion of associated remediation activities in production. Mentor, train and transfer system knowledge to other staff. Show less

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  EmblemHealth

  May 2018 - now

  Project Manager, Vendor Operations