Diane R. Paul

Harrisburg, PA *****

717-***-****

acexu1@r.postjobfree.com

Summary

A business professional with experience in analysis, testing, research,

customer service, and administrative duties. A knowledge-seeker with a

continual desire to learn and grow. Strong communication skills with a

particular emphasis in all facets of business writing and editing. Adept

at communicating and interacting with individuals of all backgrounds and

levels of business.

Technical Skills

SharePoint, ClearQuest, Outlook, Photoshop, Microsoft Office Suite

(Outlook, Word, Excel, PowerPoint)

Education

University of Phoenix - Masters of Business Administration, 2013

Susquehanna University - Bachelor of Arts, English, 1992

Professional Experience

Highmark, Inc., Camp Hill, PA

2013 - 2014

Associate Business Technical Analyst

Member of a project team tasked with the development and implementation

of a new Customer Service Call Center platform.

. Collaborated with members of the business and technical project teams

to create high quality test scripts for use in detecting defects

during the development of the customer service platform.

. Analyzed defects and determined next steps for the correction of

detected issues. Ensured that solutions were effective via regression

testing.

. Followed quality standards and best practices in the development of

new test cases and in the editing of existing cases to ensure

consistency and maintain quality standards throughout all phases of

the project.

. Performed peer review and editing of test scripts. Provided feedback

to peers and the Team Lead for the purpose of maintaining quality and

consistency throughout all phases of the project.

United Concordia Companies, Inc., Harrisburg, PA

2009 - 2013

Credentialing Specialist

Performed credentialing tasks and evaluated site audits for Dentists and

dental offices requesting participation in United Concordia's dental

insurance networks.

. Verified Dentists' qualifications via research of education and

residency, licensure, and other requirements. Researched and analyzed

discrepancies, license actions, and malpractice claim settlements.

. Researched, compiled, and presented complex cases to senior-management

committees for review and determination of participation status.

. Selected to create, edit, and maintain departmental documents and

manuals.

. Collaborated in the implementation of new processing systems and

procedures and the conversion of provider data to accommodate new systems

and procedures.

Capital Blue Cross, Harrisburg, PA

1992 - 1999

Customer Service Representative, Specialized Support 1994 - 1999

Processed customer service inquiries, questions, and appeals related to

claims and enrollment issues.

. Selected as the dedicated representative to service Capital Blue Cross

employees.

. Chosen as a representative to handle inquiries received from sources such

as the Pennsylvania Insurance Department and political figures.

. Researched, complied, and presented complex cases or otherwise difficult

issues to the Appeal Review Committee for determination. Collaborated

with various departments including Claims, Account Administration, Major

Medical, and Legal to carry out the committees' determination.

. Authored individual written responses to customers, Capital Blue Cross

employees, the Pennsylvania Insurance Department, and Legislators.

. Selected to create, edit, and maintain training manuals and perform peer

training.

Administrative Support Staff (Team Librarian) 1992 - 1994

Performed a variety of administrative and clerical duties for Managers,

Supervisors, and Computer Programmers within the IT department.

. Produced and delivered various documents, such as project proposals,

memorandums, and miscellaneous correspondence.

. Created and maintained the IT Department Procedure Manual.

. Maintained an inventory of office supplies and ordered supplies as

needed.

. Coordinated maintenance and service calls for office equipment.

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