Stephen C. DeMuro

Louisville, KY ***** 502-***-****

www.linkedin.com/in/stephen-demuro-b9943a66 adzogx@r.postjobfree.com

Summary Paragraph

Experienced business professional with a background in a wide variety of work assignments including logistics, banking, and healthcare. Well-rounded team player with a strong work ethic.

Work Experience

HUMANA, INC., Louisville, KY 2005 – 2018

Information Specialist – Grievance Team 2018 – 2018

Audit cases to ensure proper resolution of Medicare member grievances.

Utilize a wide variety of on-line databases to research and resolve member issues to successful conclusion.

Interest & Penalty Analyst 2017 – 2018

Reviewed and audited completed claims on CAS and MTV platforms, ensuring correct interest / penalties were paid.

Reviewed for approval or denial interest and penalty claims submitted via web intakes, resulting in a savings of over $1.6 million dollars over the course of the assignment.

Analyzed reports for medical records submitted for claims requiring additional information to ensure prompt processing of claims.

User System Analyst 2012 – 2017

Generated comparative analyses of actual results to expected results and report findings.

Performed testing of new applications as they relate to enhancements and system issues.

Partnered with the Information Technology department and business areas during the design of system enhancements and issue resolutions and throughout the testing process.

Resolved system issues as they relate to production processing, report applications and system output.

Received (3) Star Awards for outstanding performance.

Claims Processing Specialist, CAS Transplant Team 2011 – 2012

Processed transplant claims per daily reports for assigned states requiring knowledge of various markets and contracts.

Analyzed claims to determine whether they were transplant-related, working with triage nurse.

Consistently exceeded production requirements and quality.

Received Star Award for outstanding performance.

Team Lead, Commercial / Chrysler / Texas Teams 2007 – 2011

Provided guidance and assistance to a team of claims adjusters in processing claims on CAS platform through daily communication and individual training sessions.

Assisted supervisor in all facets of production and inventory management, e.g., preparation and dissemination of reports, audit reviews, production feedback to adjusters, etc.

Interfaced with other departments and various levels of management to reach common goals of efficient and productive claims processing, including attendance at weekly claims forum meetings and other meetings as assigned.

Received Star Award for outstanding performance in team lead role.

Claims Specialist 2005 – 2007

Processed COB (coordination of benefits) claims on CAS platform to ensure timely and accurate results.

Prepared and disseminated inventory reports on Excel spreadsheet for department leadership.

Assisted in managing compliance report for the department.

Consistently achieved targets in production and quality.

Additional Professional Experience

FINANCIAL SERVICE SOLUTIONS, Louisville, KY

Client Service Specialist

BANK OF AMERICA, Louisville, KY / Jacksonville, FL

Mortgage Loan Specialist

FIRST AMERICAN REAL ESTATE SOLUTIONS, Jacksonville, FL

Account Executive

MERCHANTS HOME DELIVERY SERVICE, Avenel, NJ

Assistant Executive Manager

GE APPLIANCES, Louisville, KY

Program Manager, Field Distribution

Education

Bachelor of Arts, Major, Minor, cum laude, Montclair State University, Upper Montclair, NJ

Technical Skills

Microsoft Excel

Word

PowerPoint

CAS

MTV

CCP2

CCA

Webstrat

CIS

Access

OBIEE

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