Catherine J Albarella ** O’Sullivan Road, Derby CT 06418-2228

aduxsj@r.postjobfree.com

aduxsj@r.postjobfree.com

Objectives

To deliver and execute high levels of service and represent an organization in both a professional and organic manner. Proficient in Sales support and service that show consistent proven results that meet or exceed project goals. Specializing in consumer satisfaction, quality assurance for business consulting, product management, provider relations and customer service. Collaboratively works with teams in being transparent in coordinating programs and project development. Deep business acumen for adhering to guidelines, compliance, structured for process improvement and organizational core values.

Present :Griffin Hospital Patient Access- Central Scheduling Fall 2021 to present Schedules patient appointments into Hospitals Medical system at the request of physician’s offices requisitions. Obtains accurate demographic & procedure information. Deep business acumen and professionalism with strong computer literacy and multitasking skills. Knowledge of medical terminology required.

Professional Experience ANTHEM BLUE CROSS BLUE SHIELD: 10/1989 – Retired in Fall 2020 Anthem Inc. companies offer health benefits and related financial services designed to change with the current times and expectations of individuals and groups. Institutional Pricing East Region: 2015- Fall 2020 Pricing and Configuration Management for the East region. A Spec II Provides accurate, timely maintenance of complex provider and reimbursement information. Primary duties may include, but are not limited to: Synchronizes data on claims and provider databases and provides expertise on business requirements for multiple business regions. Identifies, analyzes, and resolves issues for multiple system provider databases ( WGS/ACES Standalone pricer SQL Developer,Contraxx,E-map,Ultera, ARP, RFP and Provider Agreements) Participates in system testing and analysis in support of new functionality, new system processes, and business rules changes. Validate output data to be housed on provider databases and ensures adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing. Researches and resolves complex exceptions and error reports. Determines regional/cap/business indicators for multiple business areas to assure accurate reimbursement based on provider contract and area fee schedules.

Product Management: 2/2011 - 2015

Support initiatives relevant to Senior Business, Medicare Supplement lines of business. Work with internal associates on our Online store (Web-site) system to test through both a user acceptance testing (UAT) as well as System integrated testing (SIT) to ensure uploads are made. Support all product managers with high level reporting of goals and initiatives that affect the entire enterprise of Senior Business. Work with teams on Annual Medicare Notice of Changes (MNOC) for year to year changes implementation and communication to clients. Work and support team for LTC Insurance, work with vendors to ensure all privacy and compliance issues are adhered to. Work closely with Communication, Marketing and Compliance peers to ensure Policies are met for all respective states. Work with changes from each state DOI (Dept. of Insurance) to determine internal and external communications relevant to rates or benefit changes. Handle inquiries with vendors as it relates to our Long Term Care (LTC) line of business as well as Final Expense (closed life Insurance) book of business. Manage all invoices for VSP, CHCS for Administrative and Care Management as well as generate for Wireframe work invoices for PUNCH through Source Point. Network Relations Specialist, Senior Business: 2/2007- 2/2011 Conduct outreach to providers regarding claim trending issues to increase Physician understanding and, satisfaction to help promote transparencies within the organization. Managed monthly reports that are run to determine claim trends or outliers. Communicate to respective internal partners prior to any notification of outreach efforts on the Medicare Advantage updates and claim trends. Through this communication process we work with Physicians/Facilities to ensure continuity of care continues to exist for our members and to handle each case in a timely manner while maintaining all strategic initiatives set forth in Senior Business. Compiled and conducted presentations for Seminars on product based information for Physicians / Facilities and or outside vendors. Commercial Accounts- Account Service Specialist- Broker Call Center: 5/2005 - 2/2007 Communications with Broker community, market leaders and independent agents to assist in employer group issues. Dealings with complicated membership issues and or billing issues, open enrollments, extensive knowledge of direct pay, and group underwriting guidelines. This required some intervention of claim status for adjudication as well as general support of small group business for lives less than 250. Support to our Account service representatives as well as Sale associates to escalate issues to ensure member, group, market leader, and broker and agent satisfaction. Health Care Management- Professional Credentialing Representative: 9/1997 - 5/2005 Position called for prompt resolve of client inquiries regarding network contracting, Provider Re Credentialing and facility Re-Credentialing issues. Position called for extensive contact with internal and external partners to conduct such outreach with the professional provider community and institutional facilities in order to gather information for the credentialing process. This requires professionalism, tact, and diplomacy in dealing with delicate, highly confidential and potentially litigious matters. Worked in conjunction with Network relations areas and provider Network Management as it relates to either the initial Contracting of Facilities or ongoing re-credentialing. Conduct On-site Physician Site Visits, file reviews and outcomes through Anthem Provider relations system during the period of 2000-2002. Requires an extensive knowledge of Board certifications and in order to conduct such reviews of Physician, Facilities and other Ancillary staff benchmarked against internal requirements and all NCQA standards. Familiarity with JCAHO and CARF due to the responsibilities under the Anthem Provider/Facility credentialing.

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Senior Markets Sales Team (Internal Promotion): 12/1994 - 8/1997 Obtaining my State of Connecticut producer’s license in Health and Life enabled me to transition into our internal telesales area. This involved outreach calls based on the method of cold calling telemarketing to meet highly aggressive sales goals and initiatives from our senior book of business related to Medicare standardized plans. Work with internal and external associates to achieve sale goals..

Senior Markets Customer Service: 10/1989 – 11/1994 Completed an extensive customer service training on all lines of business and services. After December 1989 was recommended to our Senior Business division, overseeing all Medicare eligible members’. The area of focus was customer service intake calls and all inquiries obtained during the call to be worked and completed. Strong interpersonal and communication skills were a must in order to achieve results

State of CT Housing Authority- Town of Derby: Prior to 1989 Completed applications for Section 8 and voucher programs within the criteria set forth by the State of Connecticut for Housing (HUD) program. Assisted in administrative work related to apartment inspections and handled incoming inquiries and scheduled appointments for Director and other staff. Required excellent organization and communication skills in order to achieve daily work requirements.

Strand Brothers Manufacturing- Roosevelt Drive, Derby Prior to 1989 Manufacturing and assembly of parts for handheld staplers- Business no longer active Derby Savings Bank- Elizabeth Street Derby- Prior to 1989 Loan servicing and Mortgage servicing departments

Education & Professional Training

Sacred Heart University, Fairfield CT

State of CT. Life/Health License Connecticut No. 970271 (Life .Accident, Health or Sickness. Credit & Travel) valid through 8/2022

Current study to obtain Notary certification

Attend yearly Continuing Education courses – AD Banker Medicare Advantage & Part D Fraud Waste & Abuse, Anthem Marketing Compliance and Guidelines, Anthem

Build a Better WellPoint,

WIN- Women’s Inspired Network

Personal Information:

Catherine J Albarella (Cell) 203-***-****, (Home) 203-***-****

** Personal reference and letters of recommendations provided upon request P a g e 3 3