Administrative Support Resume

PROFESSIONAL SUMMARY:

I have over twenty years of experience in Customer Service, Claims Processing, Healthcare Insurance, Medical Terminology, Research and Development, Medicare/Medicaid and Data Analysis.

SKILLS SUMMARY:

Written and Verbal Communication
Claims Processing
Claims/Customer Service
Data Analysis
Healthcare Administration
Computer Literacy
Medical Benefits
Research and Development

TECHNICAL SKILLS:

Management Tools: Epic Tapestry AP, QC Application Lifecycle Management Tool

Project Management: MS Project 98

Office Tools: MS Office XP Professional Word, Excel, PowerPoint, Outlook, Lotus Notes, Office 365, and Sharepoint

Software: Diamond, KmateWeb, Macess Claims Systems

Data Modeling Tools: Visio Professional, Adobe Pro

Operating System: Windows 98/NT/XP/7.0/Windows 10

Databases: MS Access, Oracle, Business Objects

EMPLOYMENT HISTORY:

Administrative Support

Confidential

Responsibilities:

Organize the store management office
Execute operational administrative functions
Oversee departmental scheduling maintenance
Performed end of the night balance sheet maintenance
Distribute reports from the My Confidential ’s portal to the management team
Facilitate the onboarding process for new hires and other Human Resource functions as needed
Performed other administrative duties as assigned

Testing Analyst/User Acceptance Tester

Confidential

Responsibilities:

Assess results for documented feedback on processes and capabilities
Perform comprehensive configuration testing processes for provider contracts of benefits
Serve as technical resource for business concerns
Communicate outcomes of user testing results to business partners for sign off and approval
Create testing scenarios according to product plans for benefit configuration validation and proper claims adjudication
Perform parallel validation testing with stakeholders ensuring accurate benefit builds according to stakeholder requirements
Execute claims quality review testing to validate member benefits before claims are correctly adjudicated
Perform ICD 9 and ICD 10 testing for various claims projects
Create and present weekly status reports for stakeholder
Assist in the on boarding process for new hires

Business Process Consultant

Confidential

Responsibilities:

Conducted User Acceptance Testing (UAT) with testing and validation team
Maintained integrity of the business model testing environment
Coordinated testing schedules with project team
Triaged all incoming service request from project team
Created an internal audit process for quality control
Created a structured workflow process
Performed testing and validation configuration design process
Tested BETS system
Conducted testing for code freeze changes and updates from project team

Customer Relation Billing Rep

Confidential

Responsibilities:

Handled customer inquiries/complaints in a call center regarding a myriad of lines of business
Created a matrix design to handle customer inquiries that was utilized throughout the call center
Received escalated calls from customers with complex inquiries

Subject Matter Expert/Business Analyst

Confidential, Maryland

Responsibilities:

Supported team leads with modifying, creating and writing of test scripts for claims processing and management system
Supported project team with data and systems analysis support
Assisted in developing testing and systems deployment activities
Created documentation for project team to use for customer requirement documents
Researched and analyzed claims adjudication issues from provider network and reported findings back to Project Managers
Was a project team member for various federal mandated projects including HIPAA and ICD 10 migration

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