KEVIN RESUME 5162016
2
KEVIN RUSSELL 316 CHASE PLANTATION CIR, HOOVER, AL 35244, (205) 222-2760, [email protected] OBJECTIVE To become involved in a new environment that would allow me to continue to use my experience and commitment to serve the community, along with allowing me the opportunity to continue with the development of my business skills, experience and professional growth. EXPERIENCE 3/7/2016 TO PRESENT DST Health Solutions Birmingham, AL PROVIDER/MEMBER MAINTENANCE ANALYST Analyze requests to identify and interpret requirements to determine most appropriate solution(s) for implementing benefit changes Developed and maintained a strong working knowledge of systems functionality and clients’ benefit plans’ set-up. Understand how the system application modules interact, including priorities and dependencies. Accurately maintain BPO and client-specific policy and procedure documentation. Retrieved provider data from multiple sources (emails, spreadsheets, electronic downloads), review for understanding, prepare or format the data, and use utilities to upload into the system. Test and verify the accuracy of peers’ benefit and fee configuration data entry and setup to ensure quality and adherence to the client’s documented policies, procedures, and system requirements. Function as an advocate for the client and maintain ongoing, positive relationship with clients. Use programs such as Microsoft Office (Word, Excel, and Outlook) to help prepare reports, correspondence and other forms of communication. 1/1/2006 TO 6/17/2015 Blue Cross Blue Shield of AL Birmingham, AL INQUIRY ANALYST Investigate inquiries concerning contract benefits and determine if benefits were applied correctly and to make sure all necessary processing information is present. Used management techniques to meet deadlines by heavy research and collection of information needed to complete and apply the rules and regulations correctly. Reviewed first pass claims for potential systematic benefit issues and also to prevent fraudulent activity and abuse of medical benefits. Provided quality analysis to customer service or internal sources while maintaining total and complete discretion and confidentiality due to the sensitivity of the information. Telephone development to resolve data entry or benefit correction issues and also received phone calls regarding processing of said claims. 12/1/2001 TO AmSouth Bank (Regions Bank) Birmingham, AL
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Transcript of KEVIN RESUME 5162016
KEVIN RUSSELL 316 CHASE PLANTATION CIR, HOOVER, AL 35244, (205) 222-2760, [email protected]
OBJECTIVE
To become involved in a new environment that would allow me to continue to use
my experience and commitment to serve the community, along with allowing me
the opportunity to continue with the development of my business skills,
experience and professional growth.
EXPERIENCE
3/7/2016 TO PRESENT DST Health Solutions Birmingham, AL
PROVIDER/MEMBER MAINTENANCE ANALYST
Analyze requests to identify and interpret requirements to determine most appropriate solution(s) for implementing benefit changes
Developed and maintained a strong working knowledge of systems functionality
and clients’ benefit plans’ set-up. Understand how the system application modules interact, including priorities and dependencies.
Accurately maintain BPO and client-specific policy and procedure documentation.
Retrieved provider data from multiple sources (emails, spreadsheets, electronic
downloads), review for understanding, prepare or format the data, and use
utilities to upload into the system.
Test and verify the accuracy of peers’ benefit and fee configuration data entry and setup to ensure quality and adherence to the client’s documented policies,
procedures, and system requirements.
Function as an advocate for the client and maintain ongoing, positive relationship with clients.
Use programs such as Microsoft Office (Word, Excel, and Outlook) to help prepare
reports, correspondence and other forms of communication.
1/1/2006 TO
6/17/2015 Blue Cross Blue Shield of AL Birmingham, AL
INQUIRY ANALYST
Investigate inquiries concerning contract benefits and determine if benefits were
applied correctly and to make sure all necessary processing information is present.
Used management techniques to meet deadlines by heavy research and
collection of information needed to complete and apply the rules and regulations correctly.
Reviewed first pass claims for potential systematic benefit issues and also to
prevent fraudulent activity and abuse of medical benefits.
Provided quality analysis to customer service or internal sources while
maintaining total and complete discretion and confidentiality due to the sensitivity of the information.
Telephone development to resolve data entry or benefit correction issues and also
received phone calls regarding processing of said claims.
12/1/2001 TO AmSouth Bank (Regions Bank) Birmingham, AL
1/1/2006
PRODUCT SUPPORT SPECIALIST
Managed individual collection efforts and calls for revolving credit accounts (bankcard, HELOC, and PLC) in compliance with the FDCPA.
Utilized interpersonal communication skills to encourage resolution of delinquent
accounts and maintain customer loyalty.
Collected over $2 million on indirect loans and assisted in preventing over $4
million from charge-off in 2004.
Consistently exceeded goals through the use of product knowledge and negotiation skills.
Utilized a phone dialer system effectively to meet the needs of the customer and
the company.
SKILLS
TOTAL SYSTEMS
AMYISIS
MAGELLAN
MICROSOFT WORD (EXCEL, OUTLOOK, WORD (ALL VERSIONS)
NAVIGATOR
10 KEY
AWD
EDUCATION
8/23/2015 - PRESENT UNIVERSITY OF MONTEVALLO MONTEVALLO, AL
BUSINESS/HUMAN RESOURCES
8/15/2014 – 5/18/2014 TROY UNIVERSITY TROY, AL
BUSINESS
REFERENCES
References are available on request.
