Tracey M. Zukauskas

admwaa@r.postjobfree.com

585-***-****

Job Objective

I would like to find a position that will utilize and challenge my personable, organizational, and analytical skills while working with and assisting customers in a professional, ethical, and legal environment while providing value to the communities serviced.

Work Experience

03/20-Present Fidelis Care, Centene – Provider Relations Specialist II

Supports a portion of the Monroe County Territory. Works closely with Community Relations and Quality Teams to encourage quality member services. Works with other teams in the organization for Provider Life cycle efficiencies thru communication and partnerships.

06/19-02/20 The Lodge at Spruce Peak, A Hyatt Company – Banquet Server

As a banquet server for morning shifts, responsibilities include, but are not limited to, setting up, attending, and breaking down for buffets and serve during requested plated lunches. Personally interested in decorating for the most comforting experience.

09/18-04/19 Northwestern Medical Center – Credentialing Application Specialist

Hired to support the functionality and implementation of an upgrade to a chosen Credentialing application, while supporting existing system; Midas. Worked closely with the Chief Medical Officer and Chief Nursing Officer for regulatory requirements for Credentialing and Privileging of the Medical Staff. A member of Credentialing Committee, Medical Executive Committee, Bylaw Committee, and Quality and Safety.

11/16-09/18 Greater Rochester Independent Physicians Associates – Application Specialist

Hired to support the functionality and implementation of an upgrade to the Credentialing application, MSOW a Morrissey Application (Verity Systems 2018). Worked as Project member for validation and configuration of the application for the use of the Centralized Credentialing Organization.

02/14-09/17: Small, Local Business Management Consultant

09/15-09/17 House of Bacchus – Customer Service Specialist and Administrative Assistant

Personally responsible for email correspondence and customer points system. Runs the store as needed, but primarily responsible for data accuracy for website creation and implementation.

02/15-07/15 Pharmaca Distribution Center, Boulder CO – Shipping Specialist

Responsible to Pick, Pack, and Ship effectively and efficiently for all Online Orders and Store Orders. Worked with management on team building activities and provided suggestions for overall quality service and efficiencies.

12/14-02/15 Promo, Inc., Boulder CO – Sales and Promotion Organizer

Made direct contacts with local businesses to create promotional merchandise to expand sales. Organized events for local benefits and collaborated with Business owner for unique designs and activities. Gained strong relationships for small business support.

06/14-11/14 Boulder Valley Independent Physician Associates (BVIPA) – Administrative Assistant to Director

Responsible for all front office needs in relation to Information Technology, Office Equipment, and Event Hosting. Supported Credentialing, Referrals, and Contracting as needed. Effectively organized and documented all requirements set that had not been documented in the past. Efficiencies allowed for ease of training to new employee.

02/14-06/14 Skinny Crisps, Boulder CO – Baker and Packaging

Responsibilities included baking and seeding all products of bakery. Basic OSHA and cleaning requirements for bakery, packaging and shipping. Assisted with packaging large orders as needed.

02/14-06/14 Enterprise Car Rentals, Boulder CO – Customer Service Specialist and Driver

Responsibilities included driving customers to needed destination or auto shop. Detailed and delivered cars as needed. Provided quality service to customers and management for overall satisfaction.

01/12–04/13 Paychex, Inc. – New Case Specialist and Incident Analyst

Responsibilities began with the creation of group insurance membership files for Paychex Insurance Agency. Attention to detail and team work were necessary. Promoted to weekend support specialist for Information Technology. Responsible for completion and accuracy of batches, jobs, and access needs.

11/10–04/11 Lifetime, Inc. – Excellus Blue Cross and Blue Shield of the Rochester Area -

Physician and Ancillary Reimbursement Analyst

Responsibilities are not limited to the management of the pricing implementations in the new Transformation organization. Manages service requests, meetings, and any future processes involved in Physician/Ancillary/Facility Pricing and Implementation. Collaborates with several areas of the organization for effective and quality claim processing.

09/09–11/10 Lifetime, Inc. - Excellus Blue Cross and Blue Shield of the Rochester Area -

Provider Implementation Analyst

Responsibilities include, but are not limited to supporting the CSD division in relation to fee schedule pricing and provider disputes. Supports all legacy systems with regional role, but specifically assigned to the Rochester and Syracuse Areas. Works closely with program managers to ensure transitions, updates, and contractual obligations are met for Excellus and Monroe Plan providers.

01/08–9/09 Lifetime, Inc. - Excellus Blue Cross and Blue Shield of the Rochester Area -

Medical Service Analyst/ ClaimCheck Coder

Started in position as Data Analyst to pull and report data to clinical team through Cognos Impromptu Tool. Trained two other team members to support the reporting while worked as Claim Check 8.5 and Legacy Coder. Personally involved in the ClaimCheck 8.5 upgrade launched June 13th. Trained new member on coding and was my predecessor when leaving in 2009.

07/07–12/07 Wellcare - Senior Provider Relations Coordinator

Hired to support the provider partners of Wellcare within the Upstate New York Region. Responsible to support partnerships with all office personnel in relations to claims, credentialing, contracting and member inquiries. Provided internal solutions to processes for efficiency. Worked closely with field reps and sales team for overall productivity and profit.

08/06–04/07 Full Time Lifetime, Inc. - Excellus Blue Cross and Blue Shield of the Rochester Area

User Experience and Trainer for National Provider Identifier (NPI) Project - HIPAA Regulation

Provided training to temporary staff on internal provider data management systems throughout Lifetime, Inc. Training included documentation and informational references on TOPPS, LRSP, Facets, HBOC, and PMA. Personal and professional skills were required while facilitating team of ten interns. Worked well with all levels of staff under pressure due to short deadlines. Supported with business requirements and test cases on the project.

04/07-07/07 & 08/04–08/06 Lifetime, Inc. - Excellus Blue Cross and Blue Shield of the Rochester Area -

Provider Network Administrator

Responsible to report and submit the Provider Network Data to the Department of Health on a quarterly basis and respond timely to network inadequacies presented while working with the Compliance Division and Provider Operations. Worked with and audited provider data quality errors provided by the Department of Health while coordinating with Provider File Maintenance for data quality and integrity and Network Contracting for requirements on office visits. Process Improvements were suggested and implemented. Also responsible for the accuracy of the CMS date requirement, HSD Tables for Expansions and/or Site Visits.

06/00-8/04 Full Time Lifetime, Inc. - Excellus Blue Cross and Blue Shield of the Rochester Area -

Trading Partner Support Analyst

While working on a team of five, was responsible for the support of providers and office personnel for all electronic billing needs. Interacted with Business Support, Information Technology, Provider Relations, Customer Service, Provider Services, the provider community, and the software vendors to determine the source of the problems and find solutions pertaining to electronic claim processing. Ability to document, track, monitor, and analyze relevant issues for management. Successfully completed the HIPAA ANSI Transaction testing and approval of most software vendors and customers.

12/99-06/00 PT (Highschool Intern) Blue Cross and Blue Shield of the Rochester Area -

Trading Partner Support within IT Division

Performed interactive work within a team environment. Designed updated filing system of legal agreements. Provided technical assistance to internal and external electronic customers via telephone and email for the Utica and Syracuse locations. Solely responsible for the data integrity of the customer demographics in the new Clearinghouse system.

01/99-12/99 PT (Highschool Intern) Blue Cross and Blue Shield of the Rochester Area -

IT Division for Electronic Commerce (IVR Audio Response system)

Responsibilities included writing software specific documentation for programmers. Worked closely with Benefits Administration and developed and maintained all IVR requirements for Pharmacy & Dental conversion. Assisted with unit & system testing for new Pharmacy & Dental systems. Data entry into program application tables using Microsoft Word and Excel.

Technical Skills

*Microsoft Office Suite *IProvider Crosswalk *Mainframe Systems (TOPPS, LRSP, CAPS/UWIN, Facets)

*Training & Facilitating *GUI Clearinghouse Applications * Claim Analysis in ANSI 4010 837 Format and NSF

*iFacets (start Dec. 10) *Website Applications and Support * MSOW * EPIC Data conversion experience * Sharepoint

*Internal Source Pricing Guidelines _ Physician and Some Ancillary/Facility * Email Systems (Lotus Notes and Outlook)

Education

Bachelors of Science, Organizational Management

Roberts Wesleyan College, Chili NY

Graduation: May 2010

Associates of Science, Liberal Arts General Studies

Monroe Community College, Rochester NY 14647

Graduated: December 2006

References available upon request.

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