Medical Records, claims and customer service. Microsoft applications

Resume of: Sandra M Smith

(Sandie Smith)

**** ******* ****

Jacksonville, FL 32216

Cell: 904-***-****

*Worked at FloridaBlue (BCBSFL) 1979-2014. Senior Advisor since 2003-2014 with direct operational leadership/supervisory role on each team (PPO, Outbound, SMU & BlueCard Inbound and Outbound and Blue Card and Medical Records) supported as well as providing support as Subject Matter Expert.

*I have in past processed payroll for employees on my team as well as tracked attendance issues.

*All lines of business (PPO, HMO, Blue Options and BlueCard) experience Outbound 2006 and BlueCard SMU/BlueCard 2007-2014. Prior to Outbound PPO experience.

*Effective written and verbal skills.

*Highly successful in job performance.

*Able to encourage, motivate, enable, direct, guide and uplift employees.

*Leads TWC’s for Team as well as participated in BlueCard Senior Meetings.

*Advanced proficiency with MS Word, Excel, Real Dash and CDR Vault (phone reports). Moderate profiency creating Power Point presentation.

*In Outbound Call Center I have established relationships with multiple providers and have provided education keeping the business relationship in a positive manner and informing providers of our Availity and our BCBSFL Website tools such as CRT (Claims Recognition Tool).

*In Inbound Call Center I have been effective in diffusing irate providers/customers and bring satisfaction to our customers.

*SME'ed 3 years PPO ACS project and traveled to ACS in both Maryland and Kentucky to assist in training. SME for Legacy and Diamond, Convergence, ConvergenceX, Quest, Client Letter and ICS. Experienced with Siebel and have volunteered SME for Blue Card for Siebel.

*Extensive Claims pricing and processing under Legacy. Able correctly use APT in Diamond. Successful completion of Diamond Claims Class 2010 (Entry, Held Claims, Adjustments).

Faxing, scanning, running reports experience.

Due to family issues I retired October 2014 to assist. Family members are better and I’m able to rejoin the workforce.

References For Sandra M. Smith

Georgette Mackoul FloridaBlue 904-***-****

Karen Sikora Retired FloridaBlue 904-***-****

Alice Gundlach Friend 904-***-****

Keith Bray Friend 904-***-****

Linda Robertson Friend 904-***-****

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