Project Manager Customer Service

Seneca O'Bard

**** ******** ** *********, ** ****7

615-***-**** cell; 615-***-**** fax

Email: *******@*****.***

Professional Summary

Technical Support Professional with 13 years experience including:

Managed tier one accounts for Emdeon, increasing their revenue by 15-

20 % annually.

Years of Acct./ Project Management experience, leading to more company

productivity.

New technician training on various aspects of UB-92 and HCFA 1500

claim process.

Helped implement the Healthcare Insurance Portability and

Accountability Act. ( HIPAA)

Experience with programs such as HTML, UNIX, Java, Macintosh, DOS,

Windows, AS400/System.

Professional Experience

Cigna Healthcare (project) Franklin, TN

May 2009- June 2010 Sr. Provider Analyst

Hand-held new and existing provider's thru Cigna's enrollment process.

Tracked/Maintained communication with providers; handled up 80 calls

daily.

Assisted with provider's re-credentialing process. ( Ph. D, MD, etc)

QA'ed and Executed contracts prior to sending them out to the

provider's

Gold Skin Care Center (project) Nashville, TN

Dec. 20,2008 - Feb. 2009 Electronic Claims Billing Specialist

Responsible for daily submission of electronic claims to

clearinghouse.

Execute and review biologics and pathology approvals from various

insurance companies.

Responsible for collecting money from insurance and patients on

outstanding balances.

Communicated with management to update on daily projects and

statistics.

Emdeon Business Service 1997-2008

Implementation Project Manager

Executed and maintained project plans for new lines of business for

existing and new contracts.

Monitor implementation and update project plan to ensure deliverables

are met on time.

Assist Sales with pre-calls to client regarding implementation process

Communicate to management any barriers that may prevent client from

meeting projected live date.

Lead Project Manager

Responsible for trouble shooting and resolving daily payer production

issues for Aetna, Horizon BCBCSNJ, Coventry and Cigna.Assisted with

conducting product demonstrations for existing customers to grow their

EDI business with Emdeon.

Assisted with training newly hired and existing staff on the

functionality and application of product/ systems. Created a training

book.

Communicated updates to customers regarding status of claims,

rejections and payment.

(Unix Systems) Lead Customer Service Specialist

Documented specifications related test files and reports for

enhancements to system..

Assisted customers with claims, billing and filing for governmental

base insurance programs

Aetna US Healthcare Customer Service Analyst

Provided technical support to Aetna USHC submitters and providers.

Updated payer's database to reflect clearinghouse changes and edits.

Communicated delays, outages, downtimes and other system problems.

Assisted customers with understanding payer reports and rejections.

Point of escalation for Emdeon's customers.

Batch Systems Technical Support Specialist

Proactively monitor reports to track monthly volume, rejections, usage

of services and act according to ensure client is maximizing services.

Support customers with set-up and enrollment certification to submit

claims electronically to government and commercial payers.

Assist Customers with support issues, transmitting files and

understanding reports. Support customers with set-up and enrollment

certification to submit claims electronically to government payers.

Real-time/QA Customer Support Analyst

Provided customers with credit card/billing resolutions and reported

functionality problems.

Utilized systems to research errors within internal databases.

Tested new products prior to rolling out to provider community.

Assisted with training newly hired staff on the functionality of the

POS systems.

Logged calls and customer information for future reference.

Researched errors and inquiries within systems, which included

balancing general ledger accounts and inputting entries into our

tracking system.

Education

Watchtower Bible & Tract Society Brooklyn, NY In Progress

Trained for interpersonal dynamics, public speaking, extensive

research, and the training of individual or

groups of people.

Contact this candidate