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Administrative Assistant Customer Service

Location:
Fulton, NY, 13069
Posted:
April 20, 2015

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Resume:

Donald William Sears

*** ***** ***** **, ******, New York 13069

315-***-****

acpaah@r.postjobfree.com

Professional Positions

Position at National Grid with CPS Contemporary Personnel Staffing, Inc.

Pension Census Auditor (01/2015 - 02/2015)

Audited approximately 500 pension census files to ensure accuracy

Positions at SafeGuard Services (SGS), Subsidiary of Hewlett Packard (HP)

Quality Assurance Analyst (04/2012 - 06/2014)

Became a certified Lead Auditor through BSI Americas Inc.

Learned International Organization of Standardization (ISO) 9001:2008

Participated in 9 audits internal, external and subcontractor audits

Learned Microsoft SharePoint to utilize as a document repository

Oversaw continuous improvements and corrective actions

Outreach Coordinator (03/2011 - 04/2012)

Developed and maintained internal educational presentations

Investigator (08/2010 - 03/2011)

Learned about Home Health and Hospice Investigations

Investigated new medical providers to ensure they were not false or

fraudulent providers

Outreach Coordinator (12/2006 - 08/2010)

Learned the Medicare Advantage and the Medicare Prescription Drug Programs

Performed over 70 presentations to various audiences

Coordinated training and education over a third of the country

Investigator (01/2003 - 12/2006)

Returned $80 million to the Medicare program

Established a National Medicare Fraud Alert and a Program Vulnerability

Learned about Medicare Part B Physician Investigations

Typically worked on 50 investigations simultaneously

Positions at Empire Medicare Services (EMS) of Empire Blue Cross Blue

Shield (EBCBS)

Medicare Fraud Information Specialist (03/2001 - 01/2003)

Supervised Investigators

Coordinated fraud efforts with three different contractors in New York and

New Jersey

Received Federal Law Enforcement Training Center (FLETC) Fraud

Investigation Training

Congressional Liaison (09/1998 - 03/2001)

Resolved complaints from members of Congress and their constituents

pertaining to Medicare

Performed administrative assistant duties for management

Professional Relations (11/1997 - 09/1998)

Performed presentations to medical providers in New York, New Jersey and

Delaware

Medical Review Project Analyst (11/1995 - 11/1997)

Performed data analysis on medical denial trends and educated medical

providers

Beneficiary and Provider Telephone Inquiries (03/1993 - 11/1995)

Responded to over 100 telephone inquiries daily

Learned Medicare Part A

Claims Processing (04/1992 - 03/1993)

Entered over 400 claims daily when the average for the department was 250

claims daily

Positions at Burns International

Security Guard (1988-1994)

Inspected and reported incidents in an engine factory

Skills Summary

Customer service and Training development, Contract auditing

complaint resolution execution and

coordination

Data analysis with claims Medicare regulations and ISO regulations

or demographic FISS, CWF and MCS claim

information systems

Reports generation and File/records maintenance Microsoft Office

analysis proficient

General Education

State University of New York - Oswego, New York

Bachelor's of Arts Degree in History, graduated Cum laude, Phi Alpha Theta

Honorary Fraternity, 1991, 3.6 GPA

Cayuga county Community College - Auburn, New York

Associate's of Arts Degree in Liberal Arts, graduated Magna cum laude, Phi

Theta Kappa Honorary Fraternity, 1989, 3.5 GPA

Weedsport Junior-Senior High School - Weedsport, New York

Math, Science and Spanish Regents with Honors, CCCC and Spanish

Scholarships, 1987, 85 GPA

Weedsport Elementary School - Weedsport, New York

1980

List of Professional References

Mary Bondar - co-worker between 1996-2014 at EMS and SGS, 315-***-**** in

Clay, NY

Doretta Hogan - co-worker between 2010-2014 at SGS, 781-***-**** in

Hingham, MA

Carrie Root - co-worker between 2001-2014 at EMS and SGS, 630-***-**** in

Chicago, Illinois



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