Customer Service Sales

Lionell H Edwards

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

Pennsburg, PA 18073

Home 484-***-****

**************@*******.***

OBJECTIVE

Seeking a position in an organization that will benefit from my initiative,

capabilities, and contribution to enhance the success of your firm.

EDUCATION

Gwynedd-Mercy College

Bachelor of Science, Business Administration, Minor: Human Resource

Management, May 2004

Montgomery County Community College

Associate, Information Systems Technology, Minor: Business, May 2002

SUMMARY

Senior Finance Analyst offering 3 years of successful financial experience

specializing in recovery and reconciliation of premium capitation

healthcare accounts. Solid business background with extensive knowledge of

financial reporting, automated accounting systems. Handle escalated issues

while meeting sensitive deadlines.

Additional skills and qualification include expertise in Microsoft Word,

Excel, PowerPoint and Access. Effective communicator with customers,

management and associates. Program, repair, upgrade and customize desktop

computer systems. Skilled in Intranet and Internet technology.

EMPLOYMENT

Aetna US Healthcare, Blue Bell, PA

Medical Economics Senior Analyst, January 2006 - December 2009

Perform data interpretation, data presentation and analysis. Gather monthly

financial reports for reconciliation or retraction of payments. Coordinate

with service provider regarding their financial records. Submit monthly

checks and perform monthly data analysis reviewing variance of +5% or -5%

Retrieve data from Microsoft Access by running Queries in SQL. Report

quarterly data to my immediate manager. Support critical economic

deliverables by gathering and reviewing information. Develop and maintain

tracking tools to support key initiatives. Carry out data quality and

consistency audit to ensure data is accurate. Execute internal audits of

monthly reports. Perform variance analysis and capitation support through

research. Thorough understanding of Crystal Report, Strategic Contract

Management (SCM) software.

Aetna US Healthcare, Blue Bell, PA

Senior Customer Service Representative, August 2004 - January 2006

Subject Matter Expert (SME) Knowledge of plans, products, systems and

procedures Process Managed Care Plans HMO, PPO, POS and QPOS Examine and

process Medicare DRG's and COB claims Thorough understanding of Enterprise

Provider Database EPDB, Health Online Reference HOLR, Complaints and

Appeals Tracking Systems CATS, and Strategic Contract Management SCM

contracts Resolve customer complaints regarding billing Train new

personnel in all phases of healthcare Install updated software and

programs for service team Received multiple awards for performance,

service and quality including Perfect attendance award

Home Depot, Conshohocken, PA

Sales Associate (Part Time), January 2004 - February 2006

Demonstrate outstanding customer service to our customers Strategically

identify accounts and maintain portfolios Manage sales plan across new and

existing accounts Participates in meetings and/or store walks with

Operational leadership

REFERENCES

References Available Upon Request

Contact this candidate