Career Objective

The focus of my career has been to better myself in any position and perform the
responsibilities of the job to the best of my abilities. My organizational skil
ls, years of experience in Operations (including Enrollment, Claims and Inquirie
s) and drive for excellence will help me to accomplish these goals.
Expertise Highlights
* Claims Pricing & Adjudication
* Data/Business/Systems Analysis
* Database Management
* System experience include - Crystal Aspect, WMS2, EOS Thin Client, BI3, TPX Lo
cal 3270, TSOB
* Documentation (Manuals\Job Aides)
* Provider/legal/fraud inquiry and billing experience
* Develop and maintain effective working relationships with customers and/or bus
iness partners
* Technological experience - Microsoft Office (Word, Outlook, Excel, Access, Pow
erPoint)
Professional Experience
BLUE CROSS BLUE SHIELD OF MICHIGAN - SOUTHFIELD, MI 2000 to Present
Analyst/Interim Senior Analyst -
Operational Performance Management 2007 to Present
Key Results:
* Promoted to the position of Interim Senior Analyst for a period of four (4) mo
nths (May-Sept 2010); assisted team with contact center reporting, productivity
reports, and monthly dashboard publications
* Compile metrics from existing corporate production and reporting systems; prod
uce routine and non-routine reports, while identifying anomalies and recognizing
trends within the data
* Assist team members and external customers by answering questions and supplyin
g requested information in order to expedite timely resolution of problems
* Publish and maintain the weekly VIPER reports and graphs, and a Weekly Operati
ng Trend
Analyst - Corporate Database Department 2005 to 2007
Key Results:
* Responsibilities include timely upkeep of group benefits to the company databa
se
* Resolution of inquiries related to group benefit structures and database syste
m issues
* Provide leadership team with routine project status reports; issue, communicat
e and recommend policy decisions to achieve objectives
Pricer VII Claims Adjudicator - Professional Services Department 2002 to 2005
Key Results:
* Process complex, senior level regular claims for in state and out of state sub
missions for approval/denial
* Utilize claims finalization techniques, which demand a knowledge of systems lo
gic and to process claims via Tad Router
* Provide support to other processing claims unit functions as required through
the mobilization process of skill acquired through prior training and experience
Pricer IV Claims Adjudicator - Professional Services Department
2001 to 2002
Key Results:
* Direct data entry of in state and out of state claims
General Clerk - Professional Services Department 2000 to 2001
Key Results:
* Responsibility for the identification of in state and out of state claims, as
well as pay direction
Microfilm Clerk - Claims Support Department March 2000 to September 2000
Key Results:
* Responsible for performing micrographic filming of medical claim forms
* Cross trained in film development and claim archival procedures
Education
NORTHWOOD UNIVERSITY - LIVONIA, MI
Bachelor of Business Administration (BBA) - Business Management 2009
ITT TECHNICAL INSTITUTE - TROY, MI
Associate of Applied Science (AAS) - Computer & Electronic Engineering Technolog
y 2004