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Click here or scroll down to respond to this candidateCandidate's Name
Charlotte, NC Street Address
EMAIL AVAILABLEPHONE NUMBER AVAILABLEWork ExperienceRetail MerchandiserHallmark Cards - Kansas City, KSJune 2020 to June 2021Responsible for replenishing Hallmark greeting cards, gift items and wrapping supplies in CVS, Walgreens, Stop n Shop, Family Dollar and Dollar Tree stores. Reset seasonal cards as directed. Processed store returns and damages. Constructed new displays.Client Escalation SpecialistBANK OF AMERICA - Boston, MAMarch 2010 to March 2012Assist external customers and banking center associates in all phases of account opening and maintenanceAssist customers in selection of most appropriate banking solutions packagesCounsel and trouble shoot all areas of online bankingVerify status and place stop payments on official itemsCorrect posting and encoding errors on consumer and business accountsProcess privacy opt-out requestsAssist internal customers with inputting, cancelling and amending wire transfersResearch missing deposits for consumer and business accountsHead team sponsored events on siteMember of site-wide Diversity TeamMember of Volunteer Team for Greater Boston Food BankMember of the Black Professionals GroupInstallation LeaderHALLMARK MARKETING CORPORATION - Kansas City, MO2007 to 2009Supervised the installation crew in the revision of Hallmark aisles in drug store chainsRecruited and trained installation and merchandising representativesOrdered fixtures and productsProcessed payroll for all crew membersSenior Claims Analyst - SupervisorMEDVENTIVE - Cambridge, MA2004 to 2006Supervised claims auditors in managed care claims payments to identify and initiate recovery for inappropriately adjudicated claims.Audited Medicare claims databases for member and provider eligibility and payment issuesConsulted with provider practice management team regarding audit processes and results.Analyzed large managed care claims databases to identify claim payment discrepancies.Developed audit logic documentation.Recovered $100,000 to $1.2 million in lost revenue to provider groups annuallyDocumentation Specialist - Harvard Pilgrim Healthcare Account Quincy, MAPEROT SYSTEMS CORPORATION - Plano, TX2000 to 2004Facilitated groups of subject matter experts to develop document content.Developed and trained claims processing guidelines using Information Mapping.Post training documents on Claim Processing website using Microsoft FrontPage.Facilitated quality workgroups to improve document and web conventions.Created "Diversity at Work" a trainers guide for the account's diversity program.Facilitated "Diversity at Work" seminars.Selected as a Cultural Audit Team FacilitatorRecipient of the Claim Services MVP AwardClaim Processor/ Resolver I/II - Claim ServicesHARVARD PILGRIM HEALTH CARE - Boston, MA1996 to 1999Adjudicated and adjusted paper/electronic claims based on product and members benefits.Researched and resolved problem and high-dollar claims as assignedTrained temporary and new claims processorsProcessed coordination of benefits claims to ensure the correct insurer was paidProcessed coordination of benefits claims to ensure the correct insurer was paid.Researched and resolved problem and high dollar claims as assigned.EducationMaster of Science in ManagementEASTERN NAZARENE COLLEGE - Quincy, MABachelor of Arts in Political Science and SociologyTUFTS UNIVERSITY - Medford, MASkillsCustomer Relationship Management-10+ yearsManaged CarePresentation Skills-10+ yearsProject Management-5 yearsMerchandisingPlanogramsContent DevelopmentRecruitingProject leadership, management, documentation creation, audit-10+ years |
