Asim M. Baig
Newtown
Summary
Leader at Horizon Blue Cross and Blue Shield of NJ achieved a 15% increase in operational efficiency through financial modeling and advanced SAS Enterprise Guide skills. Expertise in cross-functional collaboration and strategic claims analysis resulted in impactful solutions that improved accuracy and streamlined complex healthcare data processes.
Overview
29
29
years of professional experience
1
1
Certification
Work History
Claims Director
S4SPEECH LLC
Morrisville
05.2024 - Current
- Successfully secured pre-authorization from diverse insurance carriers, establishing foundational coverage pathways for client therapy services.
- Managed submission of complex Speech Therapy claims to various payers, ensuring compliance with submission guidelines to facilitate prompt payment.
- Directed follow-up on rejected claims, providing detailed supplementary documentation to insurance companies, resulting in successful claim status conversion from rejected to approved for payment.
- Led claims processing team, achieving timely claim resolutions through coordinated efforts and effective communication.
- Analyzed claim data to identify trends, driving improvements in processing efficiency and enhancing overall claims management.
Financial Analyst II, Government Program Dept
HORIZON BLUE CROSS AND BLUE SHIELD OF NJ.
Hopewell
08.2017 - 04.2024
- Analyzed third-party invoices for MLTSS payments utilizing SAS EG, accurately adjudicating over $20 million in claims monthly, resulting in $2 million in quantified annual cost savings.
- Developed claims pricing models for outpatient and skilled nursing facility segments using SAS Enterprise Guide, enhancing accuracy and reliability of financial assessments.
- Constructed liability lag triangle and generated month-end financial projection reports using SAS EG and advanced Excel functions, supporting informed decision-making for financial forecasting.
- Extracted and analyzed membership activity data from complex MMR reports using SAS EG, presenting actionable findings to upper management that drove a 15% improvement in operational efficiency.
Senior ETL Developer/Data Analyst
LOGISTICS EXECUTION SYSTEMS
Philadelphia
10.2016 - 08.2017
- Collaborated with 100 hospitals to translate complex business requirements into technical specifications for data flow, process mapping, and interface design.
- Leveraged SAS for complex statistical computation, executed high-performance database querying via SQL, and implemented VBA automation within Microsoft Excel to streamline data analysis pipelines.
- Facilitated cross-functional communication to gather and document stakeholder requirements for ETL development.
Senior Actuarial Consultant, Medicare Advantage Part C
AETNA LIFE AND HEALTH INSURANCE COMPANY.
Blue Bell
02.2015 - 10.2016
- Provided data architecture and validation support for Medicare Advantage Bid submissions to the Center for Medicare and Medicaid Services (CMS), facilitating accurate and timely filings.
- Maintained and validated critical data repositories within Access Databases for annual Medicare Advantage Bid pricing submissions, ensuring data integrity and compliance.
- Delivered data support for Medicare Advantage Bids (Exhibit 1) and collaborated with external auditors on CMS-mandated plan reviews, enhancing review processes.
- Streamlined data extraction and updates for actuarial modeling using proficient SQL and SAS (Enterprise Guide), significantly improving retrieval efficiency over legacy Microsoft Access operations.
Lead Technical Analyst/Informatica Developer
X-TECHNO CONSULTING INC.
Parsippany
01.2013 - 12.2014
- Spearheaded Informatica development for Geisinger Health Plan, creating reusable transformations (Mapplets) and employing debugger tools to ensure data integrity and enhance workflow performance.
- For Comdata, designed, developed, and supported high-volume ETL processes via Informatica, successfully migrating data to the centralized data warehouse, resulting in a 20% improvement in processing efficiency.
- Led technical analysis for client migration (CatamaranRx), translating business requirements into detailed technical specifications and conducting data analysis using Aginiti to ensure successful implementation.
Finance Manager
AB & CO.
Newtown
01.2011 - 12.2012
- Contributed to strategic financial forecasting and decision-making processes, supporting organizational financial health objectives.
- Managed operational expenses and strategic pricing for new product lines, achieving 10% reduction in overall operational costs.
- Oversaw import logistics, ensured regulatory compliance, and utilized SQL for analytical monitoring of supply chain data integrity.
Actuarial Consultant II, Dental Pricing Group
METROPOLITAN LIFE INSURANCE COMPANY.
Bridgewater
07.2007 - 10.2010
- Spearheaded pricing support for Proposal Unit during peak seasonality, facilitating cross-functional technical training and assisting Dental Underwriters with accurate quoting for new and renewal business.
- Generated critical utilization studies, including the annual Procedure Class Distribution and Area Factor Study for the Dental Book of Business, communicating updated premium rates to underwriting teams.
- Managed and updated Trend Analysis metrics for Book of Business while executing detailed customer-level experience studies to monitor utilization patterns.
- Oversaw filing process for Annual Report for Dental across State Rate Filings using SERFF for in-force products, providing essential data support for multiple Dental RFPs.
Senior Actuarial Analyst, Reinsurance and Life Product Department
ING - US FINANCIAL SERVICES
West Chester
06.2004 - 04.2007
- Prepared quarterly and annual financial reinsurance settlements with verified accuracy; ensured compliance with regulatory requirements and coordinated with Accounting and Treasury for timely execution.
- Reconciled discrepancies between policy administration and reinsurance administration systems, resolving complex issues in the administration lifecycle for various life insurance products.
- Conducted complex actuarial analyses for insurance products and risk assessments.
- Developed pricing models to enhance product competitiveness in the market.
- Collaborated with cross-functional teams to address regulatory compliance requirements.
Senior Actuarial Analyst, Corporate Actuarial Department
MONY LIFE INSURANCE COMPANY
New York
10.1997 - 06.2004
- Calculated critical actuarial reserves including FASB 106, FASB 87, Non-Qualified and Qualified SSIB, and NonQualified FICA reserves for employees and Field Underwriters.
- Led reconciliation efforts for FASB 106 and FASB 87 data to ensure absolute accuracy in Life/Medical and Pension Reserves, coordinating Separate Account Certification with custodians and cross-functional teams.
- Coordinated with tax department on Asset Charge Distribution procedures for Separate Accounts, ensuring regulatory compliance.
- Mentored Actuarial Development Group Student, enhancing professional development and technical training effectiveness.
Education
Certification -
Massachusetts Institute of Technology
Cambridge, MA09-2026
Bachelor of Science - Actuarial Sciences
UNIVERSITY OF IOWA
IOWA CITY, IASkills
- Claims analysis
- Claims processing
- Liability lag analysis
- Financial modeling
- Healthcare data
- Medicare bidding
- Regulatory reporting
- Data analysis
- Data extraction
- ETL process design
- SQL querying
- SQL Server 2008
- Informatica PowerCenter
- PowerExchange software
- SAS Enterprise Guide
- Business Objects
- Cognos reporting
- Excel proficiency
- MS Excel automation
- Access database management
- Documentation reporting
- Statistical software
- APL programming
- Lynchval software
- TAI software
- Triton software
- Collaboration skills
- Training development
- Organizational planning
Certification
- Financial Mathematics
- Probability
- Interest Theory
- Time Series
- VEE (Verification by Educational Experience) - N/A
Timeline
Claims Director
S4SPEECH LLC
05.2024 - Current
Financial Analyst II, Government Program Dept
HORIZON BLUE CROSS AND BLUE SHIELD OF NJ.
08.2017 - 04.2024
Senior ETL Developer/Data Analyst
LOGISTICS EXECUTION SYSTEMS
10.2016 - 08.2017
Senior Actuarial Consultant, Medicare Advantage Part C
AETNA LIFE AND HEALTH INSURANCE COMPANY.
02.2015 - 10.2016
Lead Technical Analyst/Informatica Developer
X-TECHNO CONSULTING INC.
01.2013 - 12.2014
Finance Manager
AB & CO.
01.2011 - 12.2012
Actuarial Consultant II, Dental Pricing Group
METROPOLITAN LIFE INSURANCE COMPANY.
07.2007 - 10.2010
Senior Actuarial Analyst, Reinsurance and Life Product Department
ING - US FINANCIAL SERVICES
06.2004 - 04.2007
Senior Actuarial Analyst, Corporate Actuarial Department
MONY LIFE INSURANCE COMPANY
10.1997 - 06.2004
Certification -
Massachusetts Institute of Technology
Bachelor of Science - Actuarial Sciences
UNIVERSITY OF IOWA