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Click here or scroll down to respond to this candidateCandidate's Name
Business Support Lead IISimi Valley, CA Street Address
EMAIL AVAILABLE - PHONE NUMBER AVAILABLETo secure a fulfilling, challenging position that offers responsibility, and the opportunity for career advancement. WORK EXPERIENCEBusiness Support Lead IIBank of America - November 2010 to November 2010November 2010 - January 2014Led diverse administrative functions for a large department or complete business unitFinancial control/budgeting and consolidation, personnel processes, audit/compliance, premises and coordination of certain projects, associate training, service qualityProcess improvement, business continuity, or communicationAdministered bank programs and policies, ad may direct the development of the department's administrative policies and proceduresThorough knowledge of department's or business unit's functional operationsWorking knowledge of general bank policies, programs, procedures, and financial accounting practicesDirected workflow activitiesResponsible for the oversight and tactical execution of engagement deliverables/projectsAdvocate for quality associate experience on various project teams during transition to Legacy Asset model and after BAU is establishedLed projects initiated by the Associate Readiness groupCreated and cultivate a partnership with onsite leadership as well as leaders across the organizationIdentified challenges and focus actions that will address opportunities for improvementBuilded relationships with leaders and sites to be point of contact for questions and help them in improving and managing associate experienceCommunicated with support leaders and several levels of management routinelyAssisted Associate Readiness Design group as needed to create and/or update training job aids and training materialsCreated original LADI job aid for associates to log Level I ComplaintsTrained Case Management Leaders on LADI job aidReceived several recognition and awards from all levels of Management Collector IBank of America - April 2010 to November 2010Serviced customer loans and handled high volume inbound and outbound callsWorked with customers to establish full balance and repayment plans or settlements.Worked on an established list of accounts on an automated collections system and/or autodialerContacted delinquent, charged-off, or high-risk customers in order to secure payment and determine reason for delinquency on active loan.Resolved routine billing inquiries and negotiate payment arrangements to cure delinquent accounts.Understand and educated customers on account terms and alternate payment programs and methods, Training Specialist II Claims Processing, Coding & Keying/Document Preparation Blue Cross & Blue Shield of WNY, Inc - June 2005 to October 2009 Developed subject matter expertise and instructional design, training delivery and training evaluation skills through on-the-job training, attendance at departmental meetings, "Train the Trainer" workshops, and other developmental activities as assignedEnabled employees to achieve entry level job expectations and contribute to the attainment of business objectives through research, development, delivery and maintenance of formalized training interventions and corresponding student evaluations and performance assessmentsImproved training effectiveness and overall customer satisfaction with training interventions by designing, administering, analyzing, and responding to feedback received via training "evaluation mechanisms" (i.e. tests, surveys, teams, interviews, audits, etc.)Supported efforts to track, analyze, improve and communicate productivity and effectiveness by providing accurate student productivity, and performance recordsParticipated actively in the Quality Improvement Program and departmental quality initiatives through auditing responsibilities, departmental corrective action team projects, and the open sharing of thoughts and ideas for improving work processes, utilizing techniques and principles taught in the Quality Work GroupCompleted student, productivity, and performance records as special projects, as assigned.Complied with departmental policies and proceduresComplied with COPC proceduresHIPAA Champion for Claims Processing DepartmentUpdated and Maintained HIPAA Standard Operating Procedures for departmentTrained recently acquired Third Party Administrator, Brokerage Concepts Incorporated BCI on ASO products, Claims Processing DepartmentLiaison for Third Party Administrator Brokerage Concepts Incorporated, Claims Processing DepartmentUpdated and created Desk LevelsFacets Navigation training, PEGA Systems trainingMedical Claims Processing training, External Editing Claims ProcessingFacets 4.2 claims subteam, Facets 4.41 claims subteam, Error Trends team, Sybase 15 Upgrade Subteam Facets, Content Manager Claims subteamContent Manager Training Corporate Image Base Program, Opus Productivity, LRG Letter WriterKofax Ascent Capture 7.5 Training, KFI/KE Training, Document Preparation Training Front-End, Coding and Keying TrainingQuality Coach/Claims AnalystBlue Cross & Blue Shield of WNY - Buffalo, NY - August 2001 to June 2005 Coached staff regarding effective customer service and claims operationsAnalyzed accuracy and consistency in the processing and adjudication of claims, correspondence, and telephone calls.Reviewed, analyzed, and statistical compilation and communication of individual and departmental operating system performance.Developed of action plans or recommendations for improved procedures to address inconsistencies and problems uncovered during review process.Facets 4.01 Claims SubteamError Trends teamMedical AnalystUtilization Management - October 2000 to August 2001 Performed initial review of services to assure medical necessity.Preauthorization of services, referrals and sanction process based upon documented guidelines.Referred casework to the next level of review and in specific circumstances, to consultant staff.Monitored claims and inquiries relative to adhering to established processing time frames and notify involved departments of problems regarding the same.Researched information such as subscriber eligibility, scope of the coverage contractually provided for the benefits requested, and the medical necessity of the service.Directed providers and/or subscribers regarding the appropriate procedures to be followed and setting for treatment consistent with their contract coverage. Community Blue Customer Service RepresentativeTimely Filing Committee - August 1999 to October 2000 Answered both written and verbal inquiries including, but not limited to claim review and disposition, benefits, enrollment and eligibility, provider participation, OPL, Medicare and inter-plan transfers.Performed on-line transactions and/or adjustments, including claims.Identified potential fraud cases and forward to Special Investigation DepartmentHandled executive and priority correspondence by researching the issues involved and preparing a response for the appropriate signature.Timely Filing Committee - Reviewed each case on a single basis that is brought before the Committee for claims that are over the 90 day timely filing limit.Maintained accurate production reportsNetwork Management Representative - Assisted Network Management Specialist with questions and/or concerns voiced by external providers.EDUCATIONBusiness AdministrationVilla Maria College - Buffalo, NYSeptember 2002 to May 2003Business InstituteBryant & Stratton - Buffalo, NYJune 1979 to December 1981LawCanisus College - Buffalo, NYJune 1976 to August 1978ADDITIONAL INFORMATIONComputer Skills:AS400, LAMP, LAFA, LADI, Iportal, LPS, One Note, Snag it, Windows, Word Processing, Microsoft Word/ Works, PEGA Systems, Excel, Lotus, Display Write Geogwrite, Facets Systems, Smartboard, PowerPoint, Blue Card System ITS - formats, Genesis Home Uterine Monitoring System, CHIPS 800 Children's Hospital of Buffalo Computer System, On Demand, Opus, Kofax Ascent Capture 7.5, RRI Coding System |
