Administrative Assistant Customer Service
Resume:
Donald William Sears
*** ***** ***** **, ******, New York 13069
*********@***.***
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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