Sales Insurance

AVYANE L. OSBORNE

**** *. ********* **. 215-***-****

Philadelphia, Pa. 19131 *********@*******.***

SUMMARY OF QUALIFICATIONS

Utilizes current skills, such as communication, organizational, problem solving and analytical to meet business needs.

Implement and oversee all aspects of projects. Gather statistical information for analysis necessary to assess financial account in

order to create a budget for each event and set a yearly financial goal. Consistently follows up and follows through on all tasks.

Acts as a liaison to communicate information from one party to another to achieve overall goals. Train individuals to perform

certain tasks necessary to complete a project or move forward for an event. Meet all quotas or goals that are articulated while

maintaining business. Independently seeks out advantages to obtain new skills or applications.

EXPERIENCE

2002- Present Independence Blue Cross Philadelphia, PA

2006-Present Marketing Sales Support Coordinator – Front End Office

Solely manage the fulfillment of benefit request from Amerihealth New Jersey Brokers, Account Executives

and Associate Marketing Representatives

Provide up-to-date, accurate benefit summaries and supplemental materials within a specified timeframe.

Maintain inventory of the off-site mail house supply of benefits, flyers and giveaway items for campaigns and

open enrollments.

Oversee the production of brochure request handled by the off-site mail house.

Maintain AAA database for distribution of medical benefits for prospective clients.

Provide a monthly status report for individual insurance products while maintaining an ongoing report to

calculate the frequency of particular benefit products requested with in a one-month period in order to set a

budget for the following year.

2005- 2006 Pre-certification Specialist – Middle Office

Responsible for processing medical procedures and services for prior authorization in accordance with

established corporate medical guidelines while complying with state and federal health insurance laws.

Identify whether certain medical procedures require authorization in accord with a particular insurance and

complete requests for medical review when necessary.

2002-2005 HMO – Provider Services Representative – Back End Office

Advised providers of member’s eligibility and claims information while analyzing rejected claims.

Followed the national guidelines for claims processing, assisted providers in proper claims billing and the

reprocessing of incorrect claims.

Reviewed Statements of Remittance Sheets (SORS) from Providers and processed request for check searches

and payment when fraud may have been prevalent.

Reviewed member’s policies to verify what procedures and services the insurance company covered under each

individual member’s insurance plan.

Trained in Health Insurance databases, HIPPA regulations and knowledgeable of HCPCS codes and ICD-9

codes.

2000-2002 Wilson’s Leather Experts King of Prussia, PA

Sales Associate/ Manager Trainee

Maintain operations of the district flagship store, such as placement of sales associates and availability of

merchandise.

Complete weekly and monthly sales goals over the set amount

Assist in lowering the percentage of lost items from 7% to 0.2% in 6 months.

EDUCATION

Rosemont College

Bachelor of Science in Marketing

SOCIAL ACTIVITES

President of Episcopal Church Woman- St. George’s St. Barnabas (Terms 2006-2008; 2008-2010)

Responsible for orchestrating fundraiser events, award ceremonies, community projects, and oversees operations of the

organizations member activities. Create public announcements and advertisements in community newspapers and organizational

bulletins to promote church activities. Act as a liaison between the Vicar and the Episcopal women for church business.

Blue Crew Volunteer - Assist various community projects through Independence Blue Cross Family of Companies

organizational based volunteer program

Dress for Success (DFS) Volunteer- Assist formerly battered or abused women re-entering the work force to select a wardrobe

appropriate for Corporate America. Act as a Project Lead for IBC’s Blue Crew to assist DFS and sorting their seasonal clothing

twice a year.

Delta Sigma Pi- International Co-ed Business Fraternity- Eta Xi Chapter

College Participant of Emerging Leaders Program - A college pilot program that fostered the fundamental leadership skills of

current student leaders.

COMPUTER PROGRAM KNOWLEDGE

Microsoft: Healthcare Systems:

Word, Sliq,

Excel, MHS,

PowerPoint, BUS,

Outlook ROAM,

SharePoint and AAA,

Access MSIQ,

PVIQ,

Gach

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