Inbound Analyst

GAYL OLSON

Woodbury, Minnesota *****

*********@*****.*** 651-***-****

PROFESSIONAL PROFILE

Collaborative, highly motivated and resourceful Healthcare professional with a proven track record of success in standardizing procedures and strong leadership skills. An established record of achievement combining strengths in diverse areas of organizational development. Recognized for strong work ethic, positive attitude and the ability to develop strong relationships. Effective communicator with the ability to build rapport with management, co-workers and clients at all levels. Dedicated, goal-driven team player that thrives in a fast-paced environment.

PROFESSIONAL EXPERIENCE

BLUE CROSS BLUE SHIELD OF MINNESOTA, Eagan, Minnesota August 1998 – Present

Inbound Analyst (August 2016 – Present)

Consistently achieve 100% accuracy and exceed expectations for daily file cycle times

Pull and review reports to verify electronic enrollment files

Identify and resolve 834 compliance errors

Load and post electronic enrollment files

Serve as the main contact to support clients and vendors regarding inbound files

Provide communication with sales, clients and vendors on file issues

Accountable for 1X files

Provide communication and technical support to Enrollment Billing Representative regarding inbound electronic files and client specific questions

Serve as the Inbound Enrollment Process Subject Matter Expert (SME)

Quality Review Specialist II / Lead Tech (August 2013 – August 2016)

Conducted quality review of enrollment activities, benefit set up, billing, ID cards, and other related activities

Provided recommendations on viable solutions, workarounds, and system enhancements to reduce errors and improve overall accuracy

Compiled results and provided regular and timely assessment of individuals and departments

Communicated quality performance results and trends to staff and leadership when needed

Maintained confidentiality in the performance of accountabilities

Participated on responding to and resolving disputes/appeals of review findings

Led audit related focus groups

Assisted with identifying training needs

Built audit procedures to support enrollment for State Exchange

Supervisor (April 2005 – August 2013)

Determined work procedures, prepared schedules, and approved workflows

Evaluated and assessed workflow procedures to ensure service objectives were met

Prepared reports and monitored individual and team performance within the Resource Team (iHub, Eligibility, Corr team, Clerical team and Status Code team)

Performed interviews and hired employees

Conducted performance evaluations bi-annually for 16 staff members

Provided coaching and guidance surrounding attendance, production, and quality

Worked closely with Sales, Service, Underwriting, Finance, and customers from all areas

Identified training needs to ensure consistency along with meeting policies and procedures

Provided monthly feedback to staff surrounding individual and team performance

Trained in Six Sigma methodologies

Promoted team building activities; StrengthsFinder, BCBS Community Garden, Feed My Starving Children

Technical Specialist (December 2001 – April 2005)

Provided help to staff with complex issues surrounding cash/billing

Assisted with training, coaching, and development of process improvement

Performed monthly audits to identify training and process improvement areas

Served as a primary resource to staff for all membership related issues

Helped develop materials and guidelines for membership staff

Performed changes bills, involving rate and contract differences

Enrollment Specialist III (June 2001 – December 2001)

Enrollment Specialist II (December 1999 – June 2001)

Enrollment Specialist I (August 1998 – December 1999)

Quickly promoted through Enrollment Specialist levels due to superior reliability and efficiency

Achieved 100% audit accuracy each month

Performed complex functions: disbands, history swaps, and group audits

Researched membership referrals related to claims actions

Served as a Technical Resource, trained and mentored Enrollment Specialist I & II

Researched and processed Status Codes 08 & 09’s to release claims for final adjudication

Attended meetings with groups and/or account representatives

Investigated and applied unidentified cash to specific accounts

Performed data entry and distributed monthly billings to groups

Maintained contact with various groups and marketing representatives

Organized and completed applications in a timely manner

Researched, analyzed, and resolved applications and/or reports accurately

BHSI – BLUE CROSS BLUE SHIELD OF MINNESOTA July 1996 – August 1998

Clinic Coordinator

EDUCATION

CENTURY COLLEGE, White Bear Lake, Minnesota

Business Administration Coursework Studied – 28 credits

LAKE SUPERIOR COLLEGE, Duluth, Minnesota

General Coursework Studied - 12 credits

UNIVERSITY OF MINNESOTA, Duluth, Minnesota

General Coursework Studied - 37 credits

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