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Chadra Pinkston, MBA

Chadra Pinkston, MBA

Senior Professional Data Analyst

University of North Florida | Jacksonville, FL


My Portfolio Highlights

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Introduction to SQL

Statistical poet, weaving elegant stories with the threads of data.

My Work

Take a look at my latest work.


Intermediate SQL Queries


Introduction to SQL


Intermediate SQL

DataCamp Course Completion

Take a look at all the courses I’ve completed on DataCamp.

My Work Experience

Where I've interned and worked during my career.

IMA Medical Group | Apr 2023 - Sep 2023

Senior Data Analyst

Gathered business requirements for disease management program partnerships. Created and maintained Smartsheet survey to track patient referral coordination. Established insurance plan contacts for my team to assist in (SFTP) file transfer process implementation. Created process flow diagrams to document departmental processes to identify automation opportunities. Maintain daily hospital census/ ENS (Encounter Notification Service) file ingestion using SSIS package. Created business intelligence visualizations using the QLIK BI platform, including the Diabetes Scorecard QLIK application to track patient outcomes for IMA's Stability partnered disease management program to track provider performance and patient outcomes.
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Gainwell Technologies | Jan 2022 - Nov 2022

Senior Professional Data Analyst

Applied data analytics tools (SQL, MS Excel) to identify fee rate discrepancy trends to present findings to the finance team. Collaborated with senior staff to perform stakeholder analysis and provide recommendations for issue resolution. Addressed client’s ongoing, ad hoc reporting needs using SQL to run queries to extract SHBP/ SEHBP provider data. Developed relationships with data engineers to extract data to Power BI for audit claim visualization in adherence with service level agreement (SLA). Utilized Smartsheet to track weekly agendas and change management requests with state government client and the payor (Horizon BCBS). Consulted with information technology team to navigate through HMS system migration and software updates. • Created interactive Smartsheet dashboard for New Jersey State Department of Health client (NJ TPL) displaying fee-for-service and encounter claim fee rates, audit, and recovery percentages. Documented the dashboard monthly update process to be used as a training template. • Collaborated cross-functionally to perform data extraction and analysis for the State Government COB yield project to identify revenue opportunity in outstanding AR. • Procured implementation resources for the State Government training repository to upload to SharePoint for knowledge sharing.

Community Behavioral Health | Nov 2020 - Oct 2021

Provider Network Management Analyst

Collaborated with the Informatics and IT teams to optimize SQL data extracts that feed OLAP Cubes and Power BI Dashboards. Extracted and presented provider network utilization data displayed in PowerPoint to executive leadership for weekly network adequacy team meetings. Created ad hoc reports as requested by government regulatory bodies for procurements and press releases including relevant demographics, treatment utilization, and service gaps for target populations. Offered suggestions from a data analytics perspective to improve departmental processes. • As resident subject matter expert on Smartsheet application, assisted interdepartmental teams with form creation to collect internal customer service department and external providers to assess network adequacy data for analysis, reporting, and dashboard visualization to determine opportunity to request proposals to serve mental health sub-populations.

Independence Blue Cross | Feb 2018 - Nov 2020

Operations Analyst

Conducted preventative maintenance on group setup to avoid problematic overages. Translated statistical data into trends and projections for operational strategy to resolve group pharmacy benefit manager (PBM) inquires using MS Excel, MS Access, and SQL. Served as a trusted advisor to manage team for overall process improvement. Performed quality assurance checks on accounts payable process which reissued uncashed pharmacy reimbursements to membership. • Selected by executive leadership to participate in the Know Your Value program to improve networking, communication, and leadership skills inclusive of establishing a professional image and brand ownership. • Elected Vice President of Membership of the IBC Big Blue Toastmasters club recruited and liaised with prospective and new members. • Consulted on the process flow, requirement analysis, and testing portions of the software development life cycle (SDLC) to develop an application to assess pharmacy benefit manager (PBM) overages.

Cotiviti | Nov 2015 - Feb 2018

Audit Support Analyst (Revenue Cycle)

Scheduled and conducted meetings with the Medicare Administrative Contractors (MACs) - First Coast Service Options, Palmetto GBA, Novitas, Noridian, CGS, NGS, and WPS to resolve outstanding accounts receivable from Medicare Recovery Audit Contractor (RAC) audits. Identified risks and prepared executive level presentations to openly communicate with CMS intermediaries weekly. Manipulated large data sets using MS Excel, developed reports, interactive dashboards, internal procedures, and process documentation to abide by CMS guidelines. Monitored call queues and adherence to call center lunch and break schedules. • Reconciled CMS Medicare claims to increase departmental revenue by $1M monthly by translating technical data (error codes, concept specifications) to create informational documentation to resolve outstanding AR.

Optum | Oct 2014 - Jun 2015

Mental Health Intake Counselor

Performed mental health and substance abuse telephonic intake with risk screenings to provide outpatient insurance referrals, benefits, authorizations, and research of complaints/grievances for mental health services to Optum clients. Insured HIPAA compliance and education, member assessment and triage including referrals to their Employee Assistance Program. • Exceeded key performance indicator metrics: average handle time, first call resolution, average after call work time, average call abandonment rate.

Cotiviti | Apr 2014 - Oct 2014

CMS Provider Services Representative

Studied Medicare RAC policies and procedures to resolve provider inquiries regarding the CMS RAC audit process, criteria, and appeal rationale. Tracked interdepartmental inquires on escalated audit issues (open and peer discussion requests). • Solved escalated executive inquiries regarding the RAC audit including concept validation, claim selection • Published reference guides, including information breach documentation and training materials

DaVita Kidney Care | Oct 2011 - Feb 2014

Regional Registration Specialist

Handled complete claim processing including insurance verification, authorization, and appeal using CWF, Availity, Emdeon, and Navinet. Audited patient accounts for correct coordination of benefits (COB) setup. Assisted external customers with patient travel arrangements and hospital discharge dialysis placement. • Coached teammates on avoidable claims denials and performance standards. • Established cross functional relationships with clinical staff to ensure follow- up on patient administration. • Performed root cause analysis, trending, reporting bi-weekly for executives using Microsoft Excel (V-lookup, Pivot tables, and excel functions/ formulas).

Independence Blue Cross | Sep 2007 - Oct 2011

Billing SME- Call Center Representative

Gained extensive knowledge about public sector (Medicaid/Medicare), as well as commercial business. Audited patient billing for discrepancies and compliance checks. Researched enrollment, benefits and claims inquires for members, groups and brokers. Aided providers in interpreting member benefits and claims. • Lead department as Billing Expert resolving executive inquiries and escalated issues. • Supervised and trained agents on AdultBasic and CHIP premium billing in legacy mainframe system.

My Education

Take a look at my formal education

Certificate in Data ScienceUniversity of North Florida | 2025
Certificate in Project ManagementPenn State Great Valley | 2022
Master of Business Administration - MBA, Health Sector ManagementPenn State Great Valley | 2016
Bachelor of Science - BS, PsychologyUniversity of Pittsburgh | 2007

About Me

Chadra Pinkston, MBA

Analytical and detail-oriented professional with strong problem-solving skills. Extensive knowledge in the oversight of the healthcare industry. Looking for my next prosition as a data analyst while working on building my Data Science accumen.

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