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Medical Claims Repriced

Location:
Jackson, MS
Posted:
September 17, 2008

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Resume:

Shelia R. Brumfield

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

Terry, MS 39170

601-***-****

Objective

To obtain a position with a company where my computer skills and my technological experience can be utilized to the fullest by the employer.

Work Experience

Mississippi Health Partners March 2007 - Present

My current position involves repricing medical claims for a majority of medical providers including, but not limited to, Mississippi Baptist Medical Center and St. Dominic Hospital along with many different insurance companies including Cigna, American LifeCare and others . Some duties include repricing medical claims according to different fee schedules and adding members into system. Programs I work with are Internet Explorer, AS400, Paradox, Microsoft Excel and Word. (Versions of these programs vary).

Mississippi Department of Human Services

November 1993 - April 2006

My position at this time was Senior Systems Administrator. I was responsible for the overall administration and technical management of supervision of MIS’ Operations Unit. Monitored all aspects of computer operations and related processing including both scheduled and unscheduled functions and operations to ensure successful outcome and completion of processed jobs. Provided instructions effectively to employees for completion of assigned tasks and duties. Conducted ongoing training to employees to develop a knowledgeable production and skilled workforce to ensure adequate coverage for all shifts and established operational production tasks. Prepared Performance and Standards for employees in accordance with PAR rules. Ensured each employee’s Performance and Standards are equitable within the work group and address major assignments and duties of employees. Provided review and feedback sessions and provided documentation based on PAR rules. Maintained performance data in each individual’s supplemental employee appraisal folders. Initiate Performance Improvement Plans (PIP) for employees if rating dictates it and provide summary and documentation with first level reviewer. Used ProForm, Elixir, and DesignPro softwares to design forms Xerox Laser Printer. Used CA-7 software to schedule batch production jobs. Also used CA-View and CA-Delivery to setup reports.

Mississippi Department of Human Services

December 1992 – October 1993

My position at this time was Computer Operator Supervisor. I supervised an operations staff consisting of two Computer Operator Supervisors, three Computer Operator IIs, Data Control Supervisor and one Data Entry Clerk. Collected and analyzed data pertaining to operational issues utilizing electronic data processing systems. Coded and analyzed form design and modification of programs that produce required documents for administrative use. Monitored a multi-processor 10 CICS regions, TSO, DSPA TCH, etc. Setup and executed production jobs using CA-7 and CA-11. Communicated with users, vendors, maintenance and administrative personnel involving technical software and hardware problems. Provided troubleshooting of hardware and problem solving with the use of written and oral instructions. Complied and verified statistical operational related data for publication. Responded to special requests and monitoring of in-house activities.

Mississippi Department of Human Services

October 1988 – November 1992

My position at this time was Computer Operator II and operated the following systems: IBM AS-400, Data General Eclipse C-350, CA-7 job scheduling, MAVERICS, XEROX 8700 Laser Printer to run and monitor jobs. Changed Parm Cards when needed. Correct minor problems when jobs abend. Picked up up and delivered tapes to CDPA. Printed these tapes by inputting the correct commands on the laser printer console. Distributed print from laser and impact printer. Clean laser and impact printer as needed. Kept inventory of all forms and supplies needed in computer room.

Mississippi Department of Human Services

November 1985 – October 1988

My position at this time was Data Entry Operator II. I input data and verified as it was received. Assisted in training new operators. Spool and transmitted batch jobs on Sperry Univac Cade system. Run save tapes daily at scheduled times. Kept statistics on work received and processed for all operators. Brought system online and offline each day. Kept track of jobs processed to ensure deadlines were met in a timely manner. Assumed supervisors duties and responsibilities in her absence.

Mississippi Department of Human Services

September 1977 – November 1985

My position at this time was Data Entry Operator I. I input data and verified data as assigned by the supervisor or the assistant supervisor.

References

are available upon request.



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