Sales Medical

Ruby Hunter

Newport Beach, CA

*******@*****.*** . 949-***-****

Executive Management

Operations . Business Management . Strategic Planning

Highly accomplished visionary executive with the experience in developing

and implementing operations, training, market expansion, strategically

handle new and existing business relationships, P&L management, plus

develop and implement business plans for both startup and growth

organizations. A results-oriented individual, decisive leader with proven

success in the market, a strategic thinking, with strong negotiating and

problem solving skills. Thrive in a dynamic environment while remaining

pragmatic and focused.

Core Competencies

. International Operations . Strategic Business Planning

. Global Strategic Alliances

. Team Building & Leadership . Visionary Leadership .

P&L Management

. Management . Technology Development . Business

Development

. Revenue & Profit Growth . Risk Management

. Marketing Identification

Corporate Solutions - Irvine, California

2002-2010

Business Consultant

Find resolution for companies in need of business development, increased

revenue, and restructure operations.

> Work with attorneys on PI cases, financial structured settlements,

life care plans, benefits, i.e. disability, WC, SSI, SSDI, Medicare,

Medical, all types of insurance plans in the market.

> Work closely with a variety of companies including insurance and

healthcare organizations to streamline, increase revenue, and

restructure operations some with multiple sites

> Working knowledge with all types of coverage such as, PPO, HMO, IPA,

Manager Care, Accident injury cases, recoveries, pharmacy,

Coordination of Benefits, and all types of insurance coverage's

including Medicare, Medical, also working knowledge of all types of

billings such as hospital, medical office visits, surgery, pharmacy, x-

rays, lab testing, SNF's, PDN's, and VNA's

> Managed a field office staff and training teams with new and existing

OB/GYN medical practices and neonatology division in hospital in CA,

NV, Utah, AZ, OR, and WA

> Developed operating budgets, financial forecasting tools and business

plans

> Analyze accounts payable and receivable, billing and collections

> Built training & development, mentoring and coaching programs to

foster employee development and growth

> Strategies with the marketing department to create effective plans and

develop opportunities for new business

> Develop policies and procedures to improve efficiencies across all

company departments

> Analyze and oversee business development, sales & marketing, customer

service, benefits, processing, provider relations, contract

negotiations, and other divisions of the organization to increase the

company's bottom line.

> Provide excellent analytical and problem solving skills, build

relationships, and communicate effectively with staff, clients and

vendors

> Develop business plans and 3 to 5 year projections for start up and

existing organizations

> Develop market expansion plans domestically and internationally

> Reviewed and Outsourced one company's benefits program, saving them

$150,000

> Detect system inefficiencies and modify issues to improve business

processes

Resume cont. Ruby

Hunter -page 2

TieCare International-ICS Claims Services- Foothill Ranch, California

2000-2002

Vice President of Operations

Successfully restructured an International Third Party Administrator claims

processing organization saving the company over 600,000 in the first year

and obtained contract renewals.

> Managed all facets of the day to day operations for an International

TPA offering medical, dental, vision, disability, and travelers

insurance as well as a variety of benefits for clients world-wide

> Provided strategic and technical leadership and training to maximize

the efficiency and productivity

> Coordinated and managed multi-country assignments with the sales and

marketing division

> Strategically developed and streamlined international and domestic

operations for $200 million company

> Managed company operating budget and profit & loss, SIU, Subrogation,

and COB handling a variety of Insurance plans including reinsurance,

and basic risk

> Re-negotiated contracts with international and domestic medical

providers

> Improved functions within marketing and sales, underwriting and claims

departments resulting in increased productivity and profits for the

company which utilized several underwriters, Lloyds of London, AIG,

Global Benefits

> Increased company revenue by implementing 3 sources of savings

structures domestic and international by saving the company over

600,000 in first year

> Continuing efforts to build and expand domestic and international

relationships with clients and prospects while maintaining current

clients and providers working closely with the sales and marketing

field agents

Behning & Associates- Harrisburg, Pennsylvania

Director of Operations 1998-

2000

Created new business relations and increased revenue 60,000 of a healthcare

organization.

> Responsible for all aspects of the operations including,

reimbursement, sales, accounts payable

> Developed and negotiated contracts with vendors

> Participated in a variety of projects

> Streamlined company's work flow and improve their bottom line

> Managed staff over 100 employees

> Developed annual budget and financial reports, managed P&L

> Responsible for sales, business development, and marketing departments

> Managed all facets of the operations

Health America, Manage Care Corporation- Harrisburg, Pennsylvania

Manager of Recoveries & Claim Investigations

1994-1998

Responsible for the day to day functions of a medical claims recoveries

division involving worker's compensations, auto, property and causality as

well as claims filed with the PA Insurance Department.

> Managed staff to achieve and maintain quality and production standards

> Initiated and implemented a performance based evaluation process for

medical claims examiners.

> Improved employee performance, resulting in a 34% increase in

productivity.

> Responsible for team that handled auditing, training, claim

investigation and recoveries, subrogation

> Worked closely with corporate legal staff to resolve litigation cases

and customer complaints

> Implemented policies and procedural changes, increased productivity

while decreasing backlog

> Provided monthly reports on department activities and budgets

Resume (cont.)

Ruby Hunter -page 3

Capital Blue Cross, Harrisburg, Pennsylvania

1986-1994

Held several positions: claims adjuster, claims litigation, recoveries,

subrogation, and trainer:

Gained extensive knowledge of vendor all types of claim submission and

reimbursements structures

Worked with corporate legal council handling legal claims issues, accident

injury cases, etc... handled subrogation cases, coordination of benefits

with all types of insurance payers, accident injury cases with auto,

property & causality, and workers compensation payers.

Working knowledge with all types of coverage such as, PPO, HMO, IPA,

Manager Care, accident injury cases, recoveries, pharmacy, coordination of

benefits, and all types of insurance coverage's including Medicare,

Medical, also working knowledge of all types of billings such as hospital,

medical office visits, surgery, pharmacy, x-rays, lab testing, SNF's,

PDN's, and VNA's

Handled complaint issues that went to the PA Insurance Department which

directly affected our department

Also worked with our fraud department on claims submission suspected of

fraud.

Education

Bachelors of Science in Business Administration,

Youngstown University

Medical Terminology & Reimbursement methodologies

Anatomy & Physiology, Medical Law & Ethics

Knowledge of HIPAA regulations/ privacy laws

ICD9, CPT, UB-hospital codes, HCPCS, DRG, DME

Claims processing guidelines, fee schedules

Technical Skills

PC & Mac applications and large main frame systems, EDI

Proficient in MS Office Suite, Windows, Internet, Mac Software,

and a variety of business systems and applications

Professional and Personal Highlights

Volunteer and Mentor with Community Programs

Member with National Association for Female Executives

Coach and Mentor

Public Speaker

Yoga Student

Racquetball

Bicyclist

References provided upon request

Contact this candidate