Customer Service Administrative Assistant
Resume:
Christina Scullin
Seattle, WA 98126
************@*******.***
WORK EXPERIENCE
PACFIC MEDICAL CENTERS; Seattle, WA 2016
Report and Systems Analyst - Responsibilities include:
Producing all health plans and monthly managed care reports, including those to DoD and IMFC.
Reviewing contracts and setting up reporting strategies and schedules.
Building systems to assure complete data transfer.
Auditing monthly results of transfers and repairs deficiencies.
Auditing and maintaining the integrity of the data in the MCA module of the IDX which then transfers to the data warehouse and is utilized for all companywide reporting.
Facilitating and implementing contracts for provider and facility reimbursement, including: capitation, sub-capitation, case rates, global rates, percentage discounts, usual and customary fee schedules, RVUs, per diems, health plan schedule and networks.
Developing and conducting review to assure that rate payments meet all contractual obligations and are most advantageous for the organization.
Monitoring Medicare and Tri-care payment methodology and makes recommendations for the contract modification.
Working with the Manager of the Managed Care Operations to identify outdated contracts and vendor issues with payments. Formulating new rates, presents to clients, achieving consensus and implanting changes to IDX.
FIRST CHOICE HEALTH NETWORK; Seattle, WA 2007 – 2015
Operations Analyst/PPO Account Manager - Responsibilities included:
Defining, Writing and Implementing Business Requirements this include acting as Charter owner, Product Owner, product design, design engine rules, testing and signing off on system enhancements to client, provider and claim adjudication systems.
Completed Critical Skills for Writing Business Requirements 10/29/2014 through ASPE.
Completed internal class at First Choice Health in Project Management and Business Requirements on 03/11/2015.
Mapping Provider Categories Creating Geo Access Templates for generating Geo Access in accordance with OIC compliant requirements.
Measured ACO accessibility with Geo Access reporting for Marketing Team.
Completed Key Initiative Contract Holder enhancements for 2014 & 2015.
Analyzing provider discount methodology.
Generating disruption reporting.
Analyzing network discounts.
Generating and Analyzing provider network files used throughout the organization to support operational business needs such as: Sales and Operations, Customer Service, Enrollment, Claims, Finance, Quality and Care Management, Utilization Management and Network Management.
Manage System Enhancement Projects utilizing Scrum methodology.
Utilizing Bridge to manage contract holder rates/invoices, claims activity, EDI, remote access, stop loss, fee schedules and provider files.
Resolving claim processing and payment issues.
Designing client data through Excel and Access.
Responding to RFIs, RFPs and correspondence.
Negotiating Contract Holder agreements.
Supporting VP, Directors and Account Executives for PPO and TPA divisions.
Flexible Spending Administrator - Responsibilities included: Seattle, WA 2005 – 2007
Developing and Implementing Flexible Spending Account, HSA procedures.
Researching and Implementing IRS guidance and compliance.
Distribution of client reports and correspondence.
BENEFIT ADMINISTRATION COMPANY (BAC); Seattle, WA 2003 - 2005
Benefits Associate - Responsibilities included:
Expediting Flexible Benefit deposits, check calculation, check registers, client notifications and new enrollments for over 14,000 members.
Maintaining FSA, Pension and invoice filing system.
Managing investment participant database and FSA employer database information.
Assistant to CEO and CFO.
Formatting PowerPoint and Word Sales presentations and correspondence for CEO.
Preparing confidential correspondence and business agreements.
SOUTH SEATTLE COLLEGE; Seattle, WA 2003 - 2003
Help Desk Intern - Responsibilities included:
Programming routers, servers and switches.
Deployment, support, and troubleshooting for desktop users
Profile configuration.
Installation of Ethernet.
Installation and troubleshooting of software application and hardware devices.
Support for Novell, Unix, Windows, Web Configuration and Oracle network services.
Support for printer services.
Successful handling of helpdesk tickets.
RELEVANT SKILS AND QUALIFICATIONS
While fulfilling my internship I provided support for desktop users and successfully expedited solutions for day-to-day networking problems. I have Common Access Card Civilian clearance through the United States Department of Defense. I am proficient in GE Centricity, Milliman Model, MARA, Crystal Reports, Diamond, Bridge, Optum Geo Access, Macess, Emerald, P&W, SureTrak, TSYS, Windows Operating Systems, MicroSoft Office, Formatting Word documents, Excel, Access, Power Point, MS Sequel Server, ConfigMaker, MS. Outlook, GroupWise, Desktop Publishing-PageMaker 6.0, Business/Statistical Math and Technical/Compositional writing skills. I also bring with me over ten years of outstanding Systems Analyst, Administrative Assistant, Sales and Customer Service experience.
EDUCATION
EASTERN WASHINGTON UNIVERSITY; Cheney, WA; 2003-2003
Bachelor of Science of Technology.
GPA 3.82.
Fulfilling credit requirements through South Seattle College.
SOUTH SEATTLE COLLEGE; Seattle, WA; 2000-2003
Associate of Applied Science of Network Administration.
GPA 3.82.
Foundation Scholarship recipient and Phi Theta Kappa Honor Society member.
Completed Cisco Networking Academy.
Completed a comprehensive program Operating Systems, Network Design, Hardware Configuration, Linux, Novell, Windows 95, Windows 98, Millennium, 2000, 2000 Server, NT, IIS, Apache, HTML, Q Basic, Visual Basic, Access, and Sequel Server.
Completed additional coursework in Business Information Technology with a focus on the study of management, information science, scientific aspects of computing business and communication applications of computing.
REFERENCES AVAILABLE UPON REQUEST
Contact this candidate