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SUMMARY OF QUALIFICATIONS
Experience in the development, implementation and monitoring of processes to meet customer and
business unit’s needs. Work with claims processing, payment policies, Leadership and soft
skills. Responsible for testing training programs/modules. Designs, develops and edits training
documentation and database to support policies, procedures, system enhancements, and provider
contracting. Serve as product and process expert and resource to teams. Excellent presentation
skills, written and oral communication skills. Develops succession plans based on Needs Analysis to
provide a smooth transition without performance gaps using Adult Learning principles and
company goals. Participates in QA testing and system analysis to enhance future development of
13 years of experience with:
Writing, maintaining, and reviewing training material and help content for applications.
Reviews and maintains training material for accuracy for existing application functionality
Writes training material for new application functionality, as it is developed.
10 years of experience with:
Reads, reviews, and analyzes requirements documents for new application functionality or
changes to existing application functionality.
Coordinates with requirements document POC to ask questions and suggest
improvements/corrections during development cycle.
Assist in system analysis to facilitate future system updates
QA System Tester
SUMMARY OF WORK EXPERIENCE
Leidos, Inc. Camp Hill, PA 11/2014 – Present
Trainer Coordinator/Account Managment
Develop training materials such as User Guides, Facilitator Guides, worksheets, tests, lesson
plans, Visio flow charts
Present on and offsite training classes
System testing during system releases
Creates and maintain Help files
Assist Conversion Team with new customers by being the point of contact, presents demo’s,
answers questions and assists in converting their information to our system
Elearning creation and updates
Analyze current user functions and develop system updates
QA system tester
UNITED CONCORDIA, Harrisburg, PA 2/2014 – 11/2014
Supervisor, Provider Data Management
Supervise a staff of 16 provider data representatives, monitor inventory, time and
attendance, quality and production on a daily basis.
Develop curriculum and train new hire and in-service classes.
Acts as a liaison between departments.
Train, develop and mentor staff.
Hire, promote, review and manage performance of staff.
Assign, monitor, and review progress and accuracy of work.
Ensure continuous improvement of processes and delivery of results within assigned
Provide leadership during periods of transition as the organization changes to respond to
business opportunities/challenges, and new technologies.
Uploaded training materials using Sharepoint software, Power point and company websites
(Public domains not used per HIPAA).
COVENTRY HEALTH CARE, Harrisburg, PA 9/1998 – 2/2014
Sr. Service Center Trainer (Trainer/Business Analyst roles)
Develop, implement and monitor training programs and processes to meet or exceed
customer service requirements of service and business units within customer service
Partners with Management on several work groups to design and implement programs that
improve Attrition, Team Dynamics and system flow.
Develop, implement, and conduct training programs such as claims processing and
adjustments, payment policies and benefits, customer service, policy and procedural
changes, CPT and ICD9, Managed Care Overviews and/or remedial training on topics
identified through quality review.
Develop and conduct training assessments, competency testing as well as follow-up testing
to determine effectiveness of training programs/modules and to document employee
Analyzes Business needs and develops effective training programs to close gaps between
performance and business needs.
gathering, writing, and analyzing business requirements from users
Develops training plans based on analysis of results. An example of this would be the
development of the Claims Workshop. It was brought to my attention that staff was
lacking in certain areas of Claim Processing. Instead of pulling everyone off the floor for
several hours, I developed modules to address the necessary gaps. It was more time
efficient and targeted the exact problem. Management loved it because it saved time and
Drive proactive resolution of skill and competency deficiencies.
Serve as a coach and mentor to new Associate Trainers and Trainers.
involvement in business operations or system development and documentation
Develop and edit training documentation and database to support policies, procedures,
system enhancements, provider contracting, etc.
Partner with Business Managers and Service Leaders to manage staff development and
support skill pathing by identifying gaps in skills and competencies.
Develop training solutions and conduct/coordinate the delivery of appropriate
training. Partners with Business Managers and Service Leaders to manage staff
development and support skill pathing by identifying gaps in skills and competencies. An
example of this is the development of the Peer/Mentor Course. I established a need to
build a program in which individuals would be screened to be the mentors and then go
through several training classes on Time Management, Coaching Skills, Goal Setting,
etc… It was my 2006 CSOIP Project and went very well. I taught the classes, evaluated
the results myself and asked for outside evaluation from mentors, new hires and
management. The ADDIE model was used as my basis for building this course.
I was heavily involved in the development and maintenance of the New Hire Curriculum. I
attended and often lead bi-weekly or monthly meetings for updates.
I was active in the development and maintenance of the Come On In program. I served on
the review committee for 3 years (not consecutive) to update this program.
Often a liaison between programmers and business units to develop and teach curriculum on
new computer programs.
Serve as product and process expert and resource to teams.
Classroom training includes both new hires (phones and claims) as well as existing staff
Expert knowledge in the adult learning principles and coach associate trainers on ISD and
Excellent writing and listening skills with the ability to speak clearly and concisely to convey
25% U.S. travel presenting tailored/specific curriculum and tests based on the Plan or
Uploaded training materials using LMS software, Sharepoint, Power point and company
websites (Public domains not used per HIPAA).
Assist in system analysis to facilitate future system updates
QA System Tester
8/1999 – 4/2000
Utilization Management Service Representative
Set up, approved and serviced Authorizations for procedures, surgeries and rehab, both in
and outpatient, for all in State Plans.
Was the team liaison in working with CSO to update Authorizations so claims could be
handled in a timely manner.
Worked closely with the nursing staff to get needed approval or additional information for
Trained new employees.
9/1998 – 8/1999
Integrated Claims Processor/Customer Service Specialist for Advantra
Processed claims of varied types, focusing on Coordination of Benefits. Met all metrics
required by the Team. Also mentored new employees on claim processing.
Handled a large volume of incoming customer service calls, including supervisor calls for our
Medicare line. These calls varied in difficulty and included Benefit, Claim, Enrollment
and Plan design questions.
Provided timely and accurate follow up on varied problems or needs through careful
investigation and analysis.