Anita Ford
Business Support Lead II
Simi Valley, CA 93065
***********@*****.*** - 716-***-****
To secure a fulfilling, challenging position that offers responsibility, and the opportunity for career advancement. WORK EXPERIENCE
Business Support Lead II
Bank of America - November 2010 to November 2010
November 2010 - January 2014
Led diverse administrative functions for a large department or complete business unit
Financial control/budgeting and consolidation, personnel processes, audit/compliance, premises and coordination of certain projects, associate training, service quality
Process improvement, business continuity, or communication
Administered bank programs and policies, ad may direct the development of the department's administrative policies and procedures
Thorough knowledge of department's or business unit's functional operations
Working knowledge of general bank policies, programs, procedures, and financial accounting practices
Directed workflow activities
Responsible for the oversight and tactical execution of engagement deliverables/projects
Advocate for quality associate experience on various project teams during transition to Legacy Asset model and after BAU is established
Led projects initiated by the Associate Readiness group
Created and cultivate a partnership with onsite leadership as well as leaders across the organization
Identified challenges and focus actions that will address opportunities for improvement
Builded relationships with leaders and sites to be point of contact for questions and help them in improving and managing associate experience
Communicated with support leaders and several levels of management routinely
Assisted Associate Readiness Design group as needed to create and/or update training job aids and training materials
Created original LADI job aid for associates to log Level I Complaints
Trained Case Management Leaders on LADI job aid
Received several recognition and awards from all levels of Management Collector I
Bank of America - April 2010 to November 2010
Serviced customer loans and handled high volume inbound and outbound calls
Worked with customers to establish full balance and repayment plans or settlements.
Worked on an established list of accounts on an automated collections system and/or autodialer
Contacted delinquent, charged-off, or high-risk customers in order to secure payment and determine reason for delinquency on active loan.
Resolved routine billing inquiries and negotiate payment arrangements to cure delinquent accounts.
Understand and educated customers on account terms and alternate payment programs and methods, Training Specialist II Claims Processing, Coding & Keying/Document Preparation Blue Cross & Blue Shield of WNY, Inc - June 2005 to October 2009 Developed subject matter expertise and instructional design, training delivery and training evaluation skills through on-the-job training, attendance at departmental meetings, "Train the Trainer" workshops, and other developmental activities as assigned
Enabled employees to achieve entry level job expectations and contribute to the attainment of business objectives through research, development, delivery and maintenance of formalized training interventions and corresponding student evaluations and performance assessments
Improved training effectiveness and overall customer satisfaction with training interventions by designing, administering, analyzing, and responding to feedback received via training "evaluation mechanisms" (i.e. tests, surveys, teams, interviews, audits, etc.)
Supported efforts to track, analyze, improve and communicate productivity and effectiveness by providing accurate student productivity, and performance records
Participated actively in the Quality Improvement Program and departmental quality initiatives through auditing responsibilities, departmental corrective action team projects, and the open sharing of thoughts and ideas for improving work processes, utilizing techniques and principles taught in the Quality Work Group
Completed student, productivity, and performance records as special projects, as assigned.
Complied with departmental policies and procedures
Complied with COPC procedures
HIPAA Champion for Claims Processing Department
Updated and Maintained HIPAA Standard Operating Procedures for department
Trained recently acquired Third Party Administrator, Brokerage Concepts Incorporated BCI on ASO products, Claims Processing Department
Liaison for Third Party Administrator Brokerage Concepts Incorporated, Claims Processing Department
Updated and created Desk Levels
Facets Navigation training, PEGA Systems training
Medical Claims Processing training, External Editing Claims Processing
Facets 4.2 claims subteam, Facets 4.41 claims subteam, Error Trends team, Sybase 15 Upgrade Subteam Facets, Content Manager Claims subteam
Content Manager Training Corporate Image Base Program, Opus Productivity, LRG Letter Writer
Kofax Ascent Capture 7.5 Training, KFI/KE Training, Document Preparation Training Front-End, Coding and Keying Training
Quality Coach/Claims Analyst
Blue Cross & Blue Shield of WNY - Buffalo, NY - August 2001 to June 2005 Coached staff regarding effective customer service and claims operations
Analyzed accuracy and consistency in the processing and adjudication of claims, correspondence, and telephone calls.
Reviewed, analyzed, and statistical compilation and communication of individual and departmental operating system performance.
Developed of action plans or recommendations for improved procedures to address inconsistencies and problems uncovered during review process.
Facets 4.01 Claims Subteam
Error Trends team
Medical Analyst
Utilization Management - October 2000 to August 2001 Performed initial review of services to assure medical necessity.
Preauthorization of services, referrals and sanction process based upon documented guidelines.
Referred casework to the next level of review and in specific circumstances, to consultant staff.
Monitored claims and inquiries relative to adhering to established processing time frames and notify involved departments of problems regarding the same.
Researched information such as subscriber eligibility, scope of the coverage contractually provided for the benefits requested, and the medical necessity of the service.
Directed providers and/or subscribers regarding the appropriate procedures to be followed and setting for treatment consistent with their contract coverage. Community Blue Customer Service Representative
Timely Filing Committee - August 1999 to October 2000 Answered both written and verbal inquiries including, but not limited to claim review and disposition, benefits, enrollment and eligibility, provider participation, OPL, Medicare and inter-plan transfers.
Performed on-line transactions and/or adjustments, including claims.
Identified potential fraud cases and forward to Special Investigation Department
Handled executive and priority correspondence by researching the issues involved and preparing a response for the appropriate signature.
Timely Filing Committee - Reviewed each case on a single basis that is brought before the Committee for claims that are over the 90 day timely filing limit.
Maintained accurate production reports
Network Management Representative - Assisted Network Management Specialist with questions and/or concerns voiced by external providers.
EDUCATION
Business Administration
Villa Maria College - Buffalo, NY
September 2002 to May 2003
Business Institute
Bryant & Stratton - Buffalo, NY
June 1979 to December 1981
Law
Canisus College - Buffalo, NY
June 1976 to August 1978
ADDITIONAL INFORMATION
Computer Skills:
AS400, LAMP, LAFA, LADI, Iportal, LPS, One Note, Snag it, Windows, Word Processing, Microsoft Word/ Works, PEGA Systems, Excel, Lotus, Display Write Geogwrite, Facets Systems, Smartboard, PowerPoint, Blue Card System ITS - formats, Genesis Home Uterine Monitoring System, CHIPS 800 Children's Hospital of Buffalo Computer System, On Demand, Opus, Kofax Ascent Capture 7.5, RRI Coding System