Customer Service Administrative Assistant

SUSAN E. JESSUP

**** ***** ***** ******

Hales Corners, WI 53130 414-***-**** C

abk8vk@r.postjobfree.com Linkedin:

http://www.linkedin.com/in/susanej

BACKGROUND SUMMARY

Administrative Assistant with over 18 years of accomplishments in project

management, multitasking, working independently and as part of team.

Possesses outstanding communication, organizational and technical skills

which include:

Microsoft Office Suite (Word, Excel, Outlook)

Alpha/Numeric Data Entry skills (12000 kph)

Intermediate knowledge of Power Point 60+ wpm

PROFESSIONAL EXPERIENCE

APS HEALTHCARE - Brookfield WI 1991 to 2010

Provider of professional clinical support to help individuals understand

and manage chronic health concerns.

Client Service Coordinator II 2009 to

2010

Provide Customer Service for the Behavioral Health Division with

Referrals and Authorizations. Provide Claims Customer Services for the

Behavioral Health Division by resolving claims issues/concerns and

requesting adjustments of claims for members and providers

Client Service Coordinator II / Fulfillment Specialist

2005 to 2009

Provided an identified population for 35 accounts with print materials

pertaining to purchased chronic programs which included but was not

limited to maintaining print copy, managing inventory, coordinating

mailings schedules, data management and reporting which ensured

accuracy and timely submission

. Ensured timely transition of various Fulfillment functions for 35

clients with each client requiring excess

of 36 mailings and attachments and variable mail dates resulting in

exceeding projected completion date

by1 months with zero errors from start to completion of transition

. Assisted in the project management of print Health Risk Assessment

processing by enhancing the

guidelines which increased efficiency and exceeded projected company

and client three week turnaround by 25%. Trained staff, developed

metrics to track progress, monitored staff performance and resolved

workflow and technical obstacles

. Participated in implementation meetings of new Disease Management

accounts to understand which

products/services were purchased, associated workload and coordinated

all member communications

required in a timely manner

. Established and maintained Fulfillment cost spreadsheets for 35 clients

for executive directors to assist

in analyzing fulfillment expenses for budgets and posting on internal

web/portal site for executive directors to view as needed and have all

information in account specific documents

. Coordinated multiple data files as vendor liaison by proofing and

placing data files on vendor FTP sites

ensuring timelines were met

. Maintained internal web/portal Fulfillment site with member

communication materials for use by internal

staff when conducting health Coaching with members

. Identified member communication materials which needed review and/or

revision ensuring member

materials were current

. Initiated and scheduled meetings as needed to improve workflows between

departments in regards to

Fulfillment materials and reporting issues

Susan Jessup -

2 -

Special Reviews Coordinator/Administrative Assistant

1999 to 2005

Prepared and processed Behavioral Health and Medical UM/CM non-

certification and appeal letters in accordance with standards set by

the company, accreditation companies (URAC) and the Department of

Labor. Assisted 13 Case Managers as well as department manager.

Developed and maintained desk levels guidelines to ensure compliance

and timelines

. Handled Customer Service calls to and from facilities, providers, and

patients / subscribers related

to Inpatient and Outpatient Behavioral Health and Medical Appeals

within the HIPAA (Health

Insurance Portability & Accountability Act) guidelines

. Experienced at making independent decisions utilizing resources

available in a timely manner

. Provided telephonic follow up with subscribers, patients, providers and

facilities within 24 hours of

incoming call

. Documented all written and telephonic communication

. Verified patient eligibility at time of denied services

. Coordinated and prepared Department of Labor and account specific non-

certification letters sent to

facilities, providers and patients/subscribers. Maintained 100%

compliance for timeliness standards

. Prepared Appeal and Non-certification files for accreditation and

account audits. Maintained 100%

compliance for timeliness standards

. Assisted Case Managers and department manager with developing and

creating forms/templates and

desk guidelines to enhance efficiency.

. Coordinated various weekly, monthly, quarterly and yearly reporting for

management

. Coordinated Appeals with company Behavioral Health and Medical Review

Consultants

. Developed and maintained forms/templates and desk guidelines to enhance

efficiency

. Assisted other operations centers with Appeal & Denial related

questions

. Coordinated and scheduled departmental meetings

Senior Claims Examiner 1995 to 1999

Processed Behavioral Health claims in accordance with established

policies. Followed claims guidelines to obtain all necessary

information for accurate and timely processing. Maintained average

monthly productivity rating of Competent or better. Issued routine

form letters and correspondence either on-line or manually. Initiated

refund requests if necessary

Operations Assistant 1992 to

1995

Processed provider reimbursements and accounts payable checks.

Responsible for data entry of accounts payable.

Accounting/Claims Associate 1991 to 1992

Processed Behavioral Health claims in accordance with established

policies and Provider

Reimbursements.

EDUCATION

ASSOCIATE IN ARTS DEGREE, Travel and Tourism

Bryant and Stratton College, Milwaukee WI

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